{
 "dataset": "cna",
 "version": "2026-09-02",
 "records": 51,
 "columns": [
  "page_id",
  "state",
  "occupation",
  "cluster",
  "credential_holder",
  "licensing_level",
  "board_name",
  "board_url",
  "application_url",
  "renewal_cycle",
  "ce_hours",
  "exam",
  "fees",
  "legal_basis",
  "exam_vendor",
  "training_hours",
  "lapse_rule",
  "reciprocity",
  "last_verified",
  "source_urls",
  "page_url"
 ],
 "terms": "Free to cite and reuse with attribution to LicensingAtlas. Every value is verified against the official source named in its source_urls and dated in last_verified.",
 "rows": [
  {
   "page_id": "ak-cna",
   "state": "Alaska",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Alaska Board of Nursing — Nurse Aide Registry, Division of Corporations, Business and Professional Licensing, Alaska Department of Commerce, Community, and Economic Development",
   "board_url": "https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/NurseAideRegistry",
   "application_url": "https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/NurseAideRegistry",
   "renewal_cycle": "Biennial, on a fixed statewide date, and it turns on both work and continuing education. The Board's certificate-holder information sheet states the calendar: 'Certificates are issued for a two-year period and expire on March 31 of even-numbered years, regardless of the date of issuance, except certificates issued within 90 days of the expiration date are issued to the next biennial expiration date. One renewal notice will be sent via email or mail at least 60 days before certificate expiration to the last known email or mailing address of record. Failure to receive a renewal notice does not relieve a certificate holder from the responsibility of renewing a certificate on time.' The regulation behind it, 12 AAC 44.815, requires a renewal application, the renewal fee set in 12 AAC 02.282, and 'attestation that the applicant has met the continuing education requirements of 12 AAC 44.825 and the requirements of (c) or (d) of this section; documentation showing completion of continuing education and verification of employment will be required if the certified nurse aide is selected for audit.' The work test: 'A nurse aide certification will be renewed if the applicant was employed in a state or territory of the United States, or in a province or territory of Canada, performing CNA duties for monetary compensation for 160 hours or more during the concluding certification period' (12 AAC 44.815(c)). Note that out-of-state and Canadian work counts. Miss the 160 hours and you test again: 'An applicant who was employed as a certified nurse aide for monetary compensation for less than 160 hours during the concluding certification period may not obtain the required experience after the applicant's nurse aide certificate has lapsed and must successfully complete a competency evaluation under 12 AAC 44.850 before the certification will be renewed' (12 AAC 44.815(d)). And where there was no paid CNA work at all and the training programme finished more than two years ago, 12 AAC 44.815(g) requires 'another certified nurse aide training program approved under 12 AAC 44.835' — the whole course again. New certificate holders are eased in: an aide certified less than 12 months before the renewal period 'is not required to satisfy the requirements of (c) and (d)' (12 AAC 44.815(e)). Random audit is real and the records duty is four years: 'The division will audit a percentage of the certificate renewals... You must save your documents for at least four years so you can respond to audits' (12 AAC 02.960, as stated by the Board). Address, email and legal-name changes must be reported, the last 'within 30 days of a legal name change.'",
   "ce_hours": "24 contact hours per two-year period — a genuine continuing education requirement, which most states do not impose on nurse aides at all. 12 AAC 44.825(a): 'Except as provided in (b) of this section, an applicant for renewal of a nurse aide certification must have successfully completed 24 contact hours of continuing education during the concluding certification period.' First renewal is prorated: an applicant renewing for the first time '(1) must have successfully completed 12 contact hours of continuing education during the concluding certification period, if the applicant has been certified for at least one year during that period; and (2) is not required to complete continuing education requirements for the concluding certification period, if the applicant has been certified for less than one year during that period' (12 AAC 44.825(b)). No double-counting: 'An applicant for renewal or reinstatement of a nurse aide certification may not submit credit for the same course more than once to meet the continuing education requirements for a certification period' (12 AAC 44.825(d)). What a contact hour is, in Alaska's own definition (12 AAC 44.895(3)): 'a minimum of 50 minutes of actual organized instruction', with academic credit converting at 'one quarter academic credit equals 10 contact hours' and 'one semester academic credit equals 15 contact hours.' The Board's certificate-holder sheet pairs the education with the work test in one place: 24 contact hours plus 160 hours of paid CNA duties for an aide certified two years or more; 12 contact hours plus 160 hours for an aide certified more than one year but less than two; and neither for an aide certified less than a year. Documentation is not filed with the renewal — it is attested to, and produced only on audit.",
   "exam": "Two parts, and they may be taken separately. Credentia's Alaska handbook: 'There are two parts of the NNAAP Examination, the Written (or Oral) Examination and the Skills Evaluation. You do not need to take both of these on the same day, unless you register for the paper-pencil written/oral exam in place of the Online exam. You must pass both exams in order to be issued a Alaska CNA certification.' Written — 'The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes are left to finish.' Oral — offered to candidates who have difficulty reading English: 'The Oral Examination includes sixty (60) multiple-choice questions plus ten (10) reading comprehension/word recognition questions. If you want to take the Oral Examination, you must request it when you submit your registration form.' Skills — 'you will be asked to perform five (5) randomly selected Nurse Aide skills. You will be rated on these skills by a Nurse Evaluator'; 'You must successfully complete five (5) out of the five (5) skills in the skill form to pass the Skills Evaluation. You will have 30 minutes to demonstrate all 5 skills. When 25 minutes have elapsed the Nurse Aide Evaluator will tell you that you have 5 minutes left.' One of the randomly selected skills is a measurement skill, the 'client' is played by another candidate acting as an elderly person, and candidates must arrive 30 minutes early with two forms of signed identification, one of them photographic, an analog watch with a sweeping second hand, non-skid footwear and professional dress — 'If you do not bring the above items with you on the day of testing, you will NOT be allowed to test, and your examination fee will NOT be returned.' What Alaska's own rule requires of any approved evaluation (12 AAC 44.850(a)): an examination on the curriculum subjects that 'must offer the applicant a choice between a written examination and an oral examination'; 'a practical examination demonstrating the applicant's clinical and practical nurse aide skills'; and notification to the applicant of performance 'identifying those portions, if any, of the competency evaluation that the applicant did not pass.' The written portion may be delivered online with remote proctoring, or on paper at a test site; 'The skills examination must be done in person' (Board instructions). Attempts — 12 AAC 44.850(c) lets a failed candidate 'retake that portion of the competency evaluation that the applicant did not pass, upon payment of the examination fee', and 12 AAC 44.850(d) sets the ceiling: 'An applicant who does not successfully complete the competency evaluation after three attempts must complete a remedial course of training as required by the board. The applicant must provide proof of having fulfilled the requirements of the remedial course of training before the board will approve the applicant to retake the competency evaluation.' In-facility testing is permitted at the board's discretion: 12 AAC 44.850(e) — the board 'may allow the competency evaluation to be conducted at a facility in which the nurse aide is or will be employed, if the facility meets the requirements for the written and skills portions of the evaluation and is approved by the board.' A candidate who fails to appear twice loses the application — a vendor rule, not a Board one. Under the heading 'Abandoned Applications', Credentia's Alaska handbook says: 'If you no show for two successive examinations, your application to test will be removed and you will need to re-apply - both through CNA 365 and the Alaska Board of Nursing - before you can be approved to test again.' Nothing to that effect appears in Alaska's statutes, its regulations or any of the Board's four nurse aide forms.",
   "fees": "State fees are set in regulation and Alaska's are among the highest on this site. 12 AAC 02.282, 'Board of Nursing: fees for certified nurse aides', establishes: '(1) nonrefundable application fee for initial certification, $100; (2) examination fee, as set by and paid directly to the contracted third-party vendor; (3) certification fee for all or part of the initial biennial nurse aide certification period, $100; (4) biennial nurse aide certification renewal fee, $100; (5) certified nurse aide training program approval fee, $500; (6) reexamination fee, as set by and paid directly to the contracted third-party vendor; (7) nonrefundable fingerprint processing fee, as set out under 12 AAC 02.105(19)' — which is '$75'. The Board's own application totals, payable to 'State of Alaska': certification by examination and by endorsement are each 'Nonrefundable Application Fee: $100.00; Certification Fee: $100.00; Nonrefundable Fingerprint Processing Fee: $75.00; Total Fees Due: $275.00.' Reinstatement after a lapse is 'Reinstatement Fee: $100.00; Nonrefundable Fingerprint Processing Fee: $75.00; Total Fees Due: $175.00.' Renewal is the $100 biennial fee. A separate service fee the Board publishes on its certificate-holder sheet: 'Verification of Alaska Certificate: $20.00 fee (include other state's verification form).' Exam fees are the vendor's and Alaska's are low: Credentia's Alaska handbook prices 'Skills Evaluation ONLY $30; Written Examination ONLY $30; Oral Examination ONLY $30', notes that 'The fees listed have been established for the National Nurse Aide Assessment Program in Alaska', and states 'Fees are not refundable. If you do not bring proper identification, you will not be allowed to test, and your examination fee will not be refunded.' Payment is by credit card, pre-paid credit card or electronic voucher, and fees are 'non-refundable and non-transferable once you've paid.' Training cost is set by the approved programme and is not published by the Board. The federal prohibition of charges at 42 C.F.R. 483.152(c) still applies to an aide employed by, or holding an offer from, a facility when the programme begins.",
   "legal_basis": "[{\"citation\": \"Alaska Statutes 08.68.331 (Certification of nurse aides)\", \"what_it_governs\": \"The Board of Nursing's duty to 'issue certification as a nurse aide to qualified applicants' and its authority to adopt regulations on training, educational and other qualifications, on application, certification, renewal and revocation procedures, and on maintenance of a registry of certified nurse aides; plus its power to hold hearings and to invoke disciplinary action under as 08.01.075.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"citation\": \"Alaska Statutes 08.68.332 (Use of title)\", \"what_it_governs\": \"The title bar: 'A person may not use the title \\\"certified nurse aide\\\" or the abbreviation \\\"C.N.A.\\\" unless the person is certified under this chapter', and knowing violation is a class B misdemeanor.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"citation\": \"Alaska Statutes 08.68.333 (Registry of certified nurse aides)\", \"what_it_governs\": \"The registry itself and the abuse-finding regime: mandatory revocation and a registry entry on a board finding of abuse, neglect or misappropriation; immediate revocation without a hearing on a notice of finding under as 47.05.055; the rule that in a Medicare- or Medicaid-participating skilled nursing or nursing facility only the state survey and certification agency may make such a finding; and the narrow removal procedure for mistaken identity or a set-aside finding.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"citation\": \"Alaska Statutes 08.68.334 and 08.68.336\", \"what_it_governs\": \"The seven statutory grounds for denying certification or imposing discipline, and the department's duty to set fees under as 08.01.065 for application, examination, certification and renewal.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"citation\": \"12 AAC 44.800 – 12 AAC 44.895 (Certified Nurse Aide), Alaska Board of Nursing regulations\", \"what_it_governs\": \"The whole certified nurse aide scheme: certification by examination (.800) and endorsement (.805), emergency courtesy certification (.806), the application (.810), criminal justice information (.812), temporary certification (.814), issuance and biennial renewal with the 160-hour work test (.815), denial (.818), the graduated lapse and reinstatement ladder (.820), continuing education (.825), training programme approval (.830) and standards including the 140-hour minimum (.835), instructors (.840), curriculum (.845, .847), the competency evaluation (.850), the skills checklist (.852), changes to and discontinuation of programmes (.855, .860), the registry (.865), unprofessional conduct (.870), reinstatement of a revoked certification (.880), identification of nurse aides and trainees (.885), delegation to the department (.890) and definitions (.895).\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"citation\": \"12 AAC 02.282 (Board of Nursing: fees for certified nurse aides) and 12 AAC 02.105(19)\", \"what_it_governs\": \"The state fee schedule: $100 nonrefundable initial application fee, $100 initial certification fee, $100 biennial renewal fee, $500 training programme approval fee, examination and re-examination fees 'as set by and paid directly to the contracted third-party vendor', and the $75 nonrefundable fingerprint processing fee.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/Centralized_Licensing_Regs.pdf\"}, {\"citation\": \"42 C.F.R. 483.35(d) (Requirements for facility hiring and use of nursing aides)\", \"what_it_governs\": \"The federal four-month rule that binds Medicare- and Medicaid-participating nursing facilities — a facility 'must not use any individual working in the facility as a nurse aide for more than 4 months, on a full-time basis' unless the individual is competent and has completed an approved training and competency evaluation programme or been deemed competent. Alaska has not restated this in its own regulations; it is included because it, and not Alaskan law, is what limits uncertified aide work in nursing facilities.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.35\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal training floor of 75 clock hours with at least 16 hours of supervised practical training, which 12 AAC 44.805(1) incorporates by reference for endorsement applicants and which Alaska's own 140-hour standard exceeds; also the prohibition of charges to an aide employed by or holding an offer from a facility.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP) under the Board of Nursing. The Board's own Nurse Aide Registry page lists Credentia as its 'Nurse Aide Testing Services' with links to Credentia's help centre, candidate resources and an exam process timeline; its Certified Nurse Aide by Examination instructions tell candidates that after the Approval to Test letter arrives 'you may register for the Nurse Aide Examination (NNAAP) with Credentia Nurse Aide Credentialing Services after creating a CNA365 account (https://credentia.com/test-takers/ak)', and its accommodations paragraph calls Credentia 'our testing company'. The regulation does not name the company — 12 AAC 44.850(b) says only that a competency evaluation 'must be administered and evaluated by a nationally recognized nurse aide credentialing service approved by the board', so the vendor is an approval the board can change without amending a rule. Credentia's Alaska candidate handbook describes itself as created 'in partnership with the Alaska State Board of Nursing'. The NNAAP itself was developed by the National Council of State Boards of Nursing.",
   "training_hours": "140 clock hours minimum — 60 didactic plus 80 supervised skills and clinical — which is nearly double the federal floor and among the highest state minimums. The requirement is in regulation, not just in guidance. 12 AAC 44.835(c): a certified nurse aide training program 'must consist of at least 140 hours of training that (1) includes a minimum of 60 hours of didactic instruction that meets the requirements of 12 AAC 44.845; (2) includes a minimum of 80 hours of supervised skills and clinical training that meets the requirements of 12 AAC 44.847'. The 80 hours are themselves split: '(A) 48 hours must be in (i) a long-term care facility; (ii) an assisted living home licensed in this state that has a registered nurse or practical nurse on staff 24 hours a day; or (iii) an acute care facility; (B) at least 32 hours must be in learning and practicing the skills under the direct supervision of an approved instructor under 12 AAC 44.840'. The Board's own application instructions restate the headline figure to candidates: 'a state approved certified nurse aide training program with a minimum of 140 hours of training that includes a minimum of 60 hours of classroom instruction and 80 hours of clinical/skills training.' Before any client contact: 12 AAC 44.835(d) — 'Before having any direct contact with a client, a student must complete a minimum of 16 hours of classroom training and 16 hours of specific skill training', covering communication and interpersonal skills; infection control including standard precautions; safety and emergency procedures; respecting and promoting the rights of the client; observation, reporting and documentation of patient status and the care or service furnished; reading and recording temperature, pulse and respiration; basic elements of body functioning and the changes a nurse aide must report to a supervisor; and appropriate and safe techniques in personal hygiene and grooming, itemised down to bed bath, sponge/tub/shower bath, skin care, oral hygiene, toileting and elimination, safe transfer techniques and ambulation, and positioning. Class size is capped in rule: no more than 10 students per instructor during supervised skill and clinical training when a student is demonstrating skills on an individual or giving clinical care to a client (12 AAC 44.835(d)), and 'during classroom instruction, the ratio of students to the instructor may not exceed 20 students for each instructor' (12 AAC 44.835(j)). Two further conditions on programmes: the training 'is in addition to a nursing facility's initial employee orientation requirements' (12 AAC 44.835(e)), and each student's skills must be documented on a nurse aide skills checklist that the programme must give the student a copy of after completion (12 AAC 44.835(c)(3), 12 AAC 44.852). The training has a shelf life: the examination route requires the programme to have been completed 'not earlier than two years immediately before the date of the completed application.'",
   "lapse_rule": "Alaska grades the consequences by how long the certificate has been lapsed, and the ladder ends in a hard wall at five years. Under 12 months — the certificate can simply be renewed: 'A nurse aide certification that has been lapsed for 12 months or less may be renewed under this section' (12 AAC 44.815(f)). Lapsed one day to two years — reinstatement under 12 AAC 44.820(a) on a reinstatement application, the renewal fee and the fingerprint processing fee, all the continuing education that would have been required for the whole lapsed period (and those contact hours 'may not be used to satisfy the continuing education requirements for the next biennial certification period'), verification of paid CNA work in a U.S. state or territory or a Canadian province at the 12 AAC 44.815(c) rate for the whole lapsed period, and fingerprints. There is a shortcut: an applicant who 'has successfully completed a competency evaluation under 12 AAC 44.850 within the 24 months immediately preceding application for reinstatement is not required to meet the requirements of (a)(3) and (4)' — that is, passing the exam again replaces both the back continuing education and the back work hours (12 AAC 44.820(b)). Two to five years — everything above and the exam: 12 AAC 44.820(c) requires the back continuing education 'with at least 24 hours having been completed within the two years immediately preceding the date of application', the back work hours 'with at least 160 hours having been completed during the two years immediately preceding the date of application', and 'successful completion of a competency evaluation under 12 AAC 44.850 within the 24 months immediately preceding application for reinstatement.' Five years or more — no reinstatement at all: 'The board will not reinstate a nurse aide certification that has been lapsed for five years or more. The former holder of a nurse aide certification that has been lapsed for five years or more must reapply for a new initial certification under this chapter' (12 AAC 44.820(d)), and the Board's reinstatement instructions spell out what that means in practice: such a person 'must complete a state-approved Certified Nurse Aide training program and reapply for initial certification.' The registry entry also disappears: 'the board will remove from the registry the name of an individual holding a nurse aide certification that has been lapsed for more than two years' (12 AAC 44.865(b)) — except for abuse findings, which stay. Revocation is a different track. A finding of abuse, neglect or misappropriation is mandatory revocation plus a permanent registry entry: 'If the board finds that a certified nurse aide has committed abuse, neglect, or misappropriation of property in connection with employment as a nurse aide, the board shall revoke the nurse aide's certification and enter the finding in the registry' (as 08.68.333(b)), and on a notice of such a finding under as 47.05.055 the board 'shall immediately revoke the nurse aide's certification without a hearing' (as 08.68.333(c)). Removal is possible only on mistaken identity or where the finding has been set aside (as 08.68.333(e)), and the board also removes a finding on notice that the individual has died (12 AAC 44.865(e)). A revoked or suspended aide may apply in writing for reinstatement 'at least one year after revocation or suspension', and the board 'will, in its discretion, reinstate a certification if the board determines that the nurse aide has established that the nurse aide is competent to resume nurse aide duties with skill and safety', possibly on a supervised probationary period (12 AAC 44.880).",
   "reciprocity": "Alaska calls it certification by endorsement and it is a real application with a real fee, not a registry-to-registry transfer. 12 AAC 44.805 sets the four conditions: '(1) successful completion of a certified nurse aide training program that meets minimum federal requirements of 42 C.F.R. 483.152; (2) possession of an unencumbered nurse aide certification or registration that is issued by a state or territory of the United States, or by a province or territory of Canada, and that is current on the date of the completed application; (3) successful completion of a competency evaluation; and (4)' the English-proficiency proof for graduates of foreign pre-licensure programmes not taught in English. The Board's application instructions repeat all of it and add the paperwork: the Verification of Nurse Aide Training form (#08-4070b) sent to the training school, and the Verification of Nurse Aide Certification form (#08-4070c) sent to 'the Nurse Aide Registry for your initial and current state of certification'. Fees are the same $275 as the examination route, plus fingerprints and a state and federal background check. Two points that catch transferring aides. First, the out-of-state credential must be current when the application is approved — the Board's form says 'that is current on the date the application is approved by the Board of Nursing', while the regulation says 'current on the date of the completed application'; a candidate whose home-state certification is about to lapse should treat the later of the two as the operative date. Second, an expired out-of-state certificate does not close the door: 'If applicant does not have a current certificate but has completed a CNA program in the last 2 years, they may be eligible for certification by exam.' While the fingerprint report is outstanding the board may issue a temporary certification under 12 AAC 44.814. Alaska accepts Canadian credentials on the same terms as U.S. ones throughout — for endorsement, for the renewal work test and for reinstatement — which is unusual and is stated in the rules rather than inferred.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Alaska Board of Nursing — Nurse Aide Registry (the programme's home page). Establishes that 'Certification of nurse aides and maintenance of the nurse aide abuse registry are responsibilities of the Board of Nursing. The Board also makes final certification decisions and takes disciplinary action against nurse aides who violate the law. The Nurse Aide Registry Program is staffed by the Division of Corporations, Business, and Professional Licensing'; quotes as 08.68.360 on unlicensed practice; names Credentia as 'Nurse Aide Testing Services' with its help centre and an exam process timeline; lists online applications for Certified Nurse Aide by Endorsement and by Examination filed through a MyAlaska account; and links every paper form used on this page, the state-approved training programme list, the training programme application and the Nurse Aide Abuse Registry.\", \"url\": \"https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/NurseAideRegistry\"}, {\"label\": \"Certified Nurse Aide by Examination Application Instructions, form 08-4069 (Rev. 11/05/2025), Alaska Board of Nursing. Establishes the governing law ('Alaska Statute 08.68 is the statute related to nursing in Alaska; 12 AAC 44.800-12 AAC 44.895 are the regulations'), the five eligibility routes including 'a state approved certified nurse aide training program with a minimum of 140 hours of training that includes a minimum of 60 hours of classroom instruction and 80 hours of clinical/skills training', the requirement that every route still pass the 12 AAC 44.850 competency evaluation, the fee total ($100 + $100 + $75 = $275), the Verification of Nurse Aide Training form 08-4069b, the FD-258 fingerprint card and the as 12.62.400 background check, the English-proficiency options and the exclusion of the Online IELTS Indicator and TOEFL at Home tests, the Approval to Test letter, and the registration route to Credentia's CNA365 at credentia.com/test-takers/ak.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4069.pdf\"}, {\"label\": \"Certified Nurse Aide by Endorsement Application Instructions, form 08-4070 (Rev. 06/18/2025), Alaska Board of Nursing. Establishes the endorsement conditions — training meeting 42 C.F.R. 483.152, an unencumbered out-of-state or Canadian certification 'current on the date the application is approved by the Board of Nursing', a completed competency evaluation, and English proficiency where applicable — the $275 fee total, the two verification forms (08-4070b for training, 08-4070c for certification), and the note that an applicant without a current certificate who completed a CNA programme in the last two years 'may be eligible for certification by exam.'\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4070.pdf\"}, {\"label\": \"Reinstatement of Nurse Aide Certification Application Instructions, form 08-4365 (Rev. 01/08/2025), Alaska Board of Nursing. Establishes that 'The board will not reinstate a nurse aide certification that has been lapsed for five years or more' and that such a person 'must complete a state-approved Certified Nurse Aide training program and reapply for initial certification'; the reinstatement fee total ($100 + $75 = $175); the back continuing education and back paid-work requirements 'with at least 160 hours having been completed within the two years immediately preceding the date of application'; the alternative of a competency evaluation completed within the preceding 24 months; and the fallback of retaking both parts of the examination through Credentia.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4365.pdf\"}, {\"label\": \"Certificate Holder Information – Nurse Aides, form 08-4227 (Rev. 07/24/2025), Alaska Board of Nursing. Establishes the renewal calendar ('Certificates are issued for a two-year period and expire on March 31 of even-numbered years, regardless of the date of issuance, except certificates issued within 90 days of the expiration date are issued to the next biennial expiration date'), the 60-day renewal notice and the warning that failure to receive it does not excuse a late renewal, the continued-competency tiers (24 contact hours plus 160 paid hours; 12 contact hours plus 160 paid hours; neither, for holders of under a year), the random audit under 12 AAC 02.960 and the four-year record-retention duty, the 30-day legal-name-change duty, the business license requirement for independent contractors, and the $20 verification fee.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4227.pdf\"}, {\"label\": \"Statutes and Regulations — Nursing (Alaska Division of Corporations, Business and Professional Licensing, September 2025, Rev. 9/28/2025). The Board's own compiled as 08.68 and 12 AAC 44, and the source of every statutory and regulatory quotation on this page: As 08.68.331-.336 and the whole certified nurse aide article 12 AAC 44.800 through 12 AAC 44.895, including the 140-hour training standard and its 60/80 and 48/32 splits at 12 AAC 44.835(c), the pre-contact 16-plus-16 hours and the 10:1 and 20:1 instructor ratios at 12 AAC 44.835(d) and (j), the competency-evaluation standard and three-attempt limit at 12 AAC 44.850, the biennial renewal and 160-hour work test at 12 AAC 44.815, the continuing education rule at 12 AAC 44.825, the graduated lapse ladder at 12 AAC 44.820, the registry at 12 AAC 44.865, reinstatement of a revoked certification at 12 AAC 44.880 and the name-tag rule at 12 AAC 44.885. The document itself states that where it differs from the official Alaska Statutes or Alaska Administrative Code, 'the official versions will apply.'\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/NursingStatutes.pdf\"}, {\"label\": \"Centralized Licensing Regulations, 12 AAC 02 (Alaska Division of Corporations, Business and Professional Licensing). Establishes 12 AAC 02.282, 'Board of Nursing: fees for certified nurse aides', with the $100 application, $100 initial certification, $100 biennial renewal and $500 training programme approval fees and the vendor-set examination and re-examination fees, and 12 AAC 02.105(19), 'nonrefundable fingerprint processing fee, $75.'\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/Centralized_Licensing_Regs.pdf\"}, {\"label\": \"Approved Nurse Aide Training Programs, form 08-4943 (Rev. 02/13/2026), Alaska Board of Nursing. The state's own current list of approved programmes by region, with addresses, telephone numbers and named contacts, including programmes restricted to particular populations such as high school students. Its revision date is the freshest of any Alaska nurse aide document read.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4943.pdf\"}, {\"label\": \"Nurse Aide Training Program Application, form 08-4753 (Rev. 09/08/2020), Alaska Board of Nursing. The provider-side application referenced by 12 AAC 44.830; noted here because its revision date is the oldest of the Board's nurse aide forms.\", \"url\": \"https://www.commerce.alaska.gov/web/Portals/5/pub/nua4753.pdf\"}, {\"label\": \"Alaska Certified Nurse Aide Written (or Oral) Examination & Skills Evaluation Candidate Handbook, April 2024 (Credentia, 'created by Credentia in partnership with the Alaska State Board of Nursing'). Establishes the NNAAP structure (70 written multiple-choice questions in two hours; an oral alternative of 60 multiple-choice plus 10 reading comprehension/word recognition questions; five randomly selected skills in 30 minutes, all five to be passed, with a five-minute warning at 25 minutes), the Alaska exam fees ('Skills Evaluation ONLY $30; Written Examination ONLY $30; Oral Examination ONLY $30... established for the National Nurse Aide Assessment Program in Alaska'), the CNA365 registration flow and its 10-day test-centre and 24-hour online booking deadlines, the identification and equipment rules including the analog watch and non-skid footwear, the abandoned-application rule after two no-shows, and the three-strike remedial-course consequence.\", \"url\": \"https://credentia.com/storage/ak-handbook_2024.pdf\"}, {\"label\": \"Credentia — Alaska test takers page. The vendor's live Alaska landing page, which the Board's own application instructions send candidates to by name and address.\", \"url\": \"https://credentia.com/test-takers/ak\"}, {\"label\": \"Alaska Division of Corporations, Business and Professional Licensing — Search Professional Licenses. The public certificate lookup; 'Nurse Aides' is one of the selectable programmes and the form's own fields are the source of the search options listed under Verify a license on this page.\", \"url\": \"https://www.commerce.alaska.gov/cbp/main/Search/Professional\"}, {\"label\": \"Alaska Board of Nursing — Nursing Statutes and Regulations. The Board's own statutes-and-regulations page, which states that 'AS 08.68 and regulations 12 AAC 44 specifically govern nursing practice. AS 08.01 - 08.03 and regulations 12 AAC 02 apply to all professions regulated by the division', and links the compiled PDFs used here.\", \"url\": \"https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofNursing/NursingStatutesandRegulations\"}, {\"label\": \"42 C.F.R. 483.35 (eCFR current text). The federal nursing-services rule containing the four-month limit on a facility's use of an uncertified nurse aide, which Alaska has not restated in its own regulations.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-B/section-483.35\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR current text). The federal training-programme standard that 12 AAC 44.805(1) incorporates by reference for endorsement applicants.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/ak-cna/"
  },
  {
   "page_id": "al-cna",
   "state": "Alabama",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Alabama Department of Public Health (ADPH) — Bureau of Health Provider Standards, Division of Health Care Facilities (Alabama Certified Nurse Aide Registry)",
   "board_url": "https://www.alabamapublichealth.gov/providerstandards/index.html",
   "application_url": "https://dph1.adph.state.al.us/NurseAideRegistry/",
   "renewal_cycle": "There is no renewal. ADPH answers it in one line: 'Does the Alabama Nurse Aide Registry have a renewal process for Certified Nursing Assistants? No, there is no renewal process for the Alabama Nurse Aide registry. Certifications are kept active if the individual is currently working or within the past 24 months worked in a nursing home, hospital, home health agency, hospice agency, or mental health facility.' What replaces renewal is a work test the aide must keep satisfying: 'You must work at least 8 hours every 24 months in a nursing home, hospital, home health agency, hospice agency, or mental health facility for paid compensation. Volunteer work does not count. Private sitting, assisted living facilities, and doctor's office work does not count.' ADPH sets out the conditions as a list — 'Work is for monetary compensation. Work as a nurse aide, performing direct patient care. Work is under the supervision of a registered nurse. Total time worked equals eight (8) hours or more every 24 months in a nursing home, hospital, home health agency, hospice agency, or mental health facility.' The dates: 'Initially, the expiration date is 24 months from the date the individual successfully completed the competency evaluation/test', and thereafter 'The Active status extends 24 months beyond the last date worked' at one of those five kinds of employer. Because the aide files nothing, the aide is also not the one who reports the work: ADPH says 'Information regarding your status on the registry can be obtained from your former or current employer', and 'the State of Alabama does not maintain employment or work history records for Nurse Aides.' No ADPH source we checked states a form, a deadline or an address by which an aide can report qualifying work directly, which is the single most consequential gap in Alabama's published process.",
   "ce_hours": "Continuing education does not keep a registry listing alive in Alabama — work does. ADPH is explicit: 'Do CEU's keep a certification active? No. Skilled nursing facilities are required to provide 12 hours of mandatory continuing education to CNA's (12 per year according to the date of hire for the CNA).' The 12 hours are a duty the state puts on the facility, and the rule behind them is Ala. Admin. Code r. 420-5-10-.03(15): 'The facility must complete a performance review of every nurse aide at least once every 12 months, and must provide regular in-service education based on the outcome of these reviews. The in-service training must: (a) Be sufficient to ensure that continuing competence of nurse aides, but must be no less than 12 hours per year; (b) Address areas of weakness as determined in nurse aides' performance reviews and may address the special needs of residents as determined by the facility staff; and (c) For nurse aides providing services to individuals with cognitive impairments, also address the care of the cognitively impaired.' The companion duty is r. 420-5-10-.03(16): 'The facility must ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents' needs, as identified through resident assessments, and described in the plan of care.' So an Alabama nurse aide who does 12 hours of in-service every year but stops working still loses registry status at 24 months, and an aide who works eight paid hours in 24 months keeps it whether or not any in-service was delivered.",
   "exam": "Two parts — a written (or oral) knowledge test and a hands-on skills test — and you must pass both. ADPH states the requirement without describing the test: 'An individual must successfully complete a State-approved nurse aide training and competency evaluation program and pass both the written and skills tests to be listed on the nurse aide registry.' The shape of the test then depends on which of the two approved providers your training program uses, and the two differ in ways candidates notice. Prometric: 'The Written Test consists of 55 multiple-choice questions. You will have 90 minutes to take the test.' The skills test is five skills — 'The time allowed for the Clinical Skills test ranges from 31 minutes to 40 minutes based on the skills you are asked to perform' and 'To pass the Clinical Skills Test, you must pass all five skills. To pass a skill, you are not required to perform the skill perfectly, but you are required to demonstrate competency of the skill.' The two tests may be taken in either order: 'You are not required to pass one test before taking the other.' Candidates test at approved regional test centres or in facilities, must bring proof of completion of a state-approved training program, and 'You should arrive at least 30 minutes before your scheduled test appointment.' Credentia (NNAAP): 'The Written Examination consists of seventy (70) multiple-choice questions written in English... An Oral Examination may be taken in place of the Written Examination if you have difficulty reading English. The Oral Examination consists of sixty (60) multiple-choice questions and ten (10) reading comprehension questions. If you want to take the Oral Examination, you must request it when you submit your application.' Skills: 'you will be asked to perform five (5) randomly selected nurse aide skills. You will be given thirty (30) minutes to complete the five (5) skills... You must perform all five (5) skills correctly to pass the Skills Evaluation.' Credentia offers the oral examination in English or Spanish, runs its applications and scheduling through an online account system, and offers online proctored written and oral exams as well as test-centre and in-facility testing. Retesting: Prometric — 'You have three opportunities to take and pass both parts of the competency exam. Each attempt requires the payment of a new test fee. You are only required to retake the test you failed'; and if you fail and remain eligible, 'you may retake the test(s) on the same day at the discretion of the test site based on availability', an option Prometric says 'is not encouraged since candidates are not likely to have adequate opportunity to prepare.' Both providers' Alabama materials are published on their own Alabama pages; ADPH's Nurse Aide Training Program handbook is what points candidates to them.",
   "fees": "Alabama charges no state fee for a registry listing, and publishes none. No application fee, listing fee, certificate fee or renewal fee appears on the Alabama Certified Nurse Aide Registry site (search page, FAQ, contacts and training-guide pages), in the ADPH Nurse Aide Training Program handbook, on ADPH's Bureau of Health Provider Standards pages, or anywhere in Ala. Admin. Code ch. 420-5-10 — all checked. The state also runs no renewal, so there is no recurring state charge to publish. What a candidate actually pays goes to the test provider the training program uses. Prometric publishes its Alabama schedule as 'Clinical Skills Test $45; Knowledge (written or oral) Test $40; Test Site Administration Fee $40', payable to the test site by credit card, money order or cashier's cheque — 'Personal checks and cash are not accepted' — with 'Test fees are nonrefundable and nontransferable', no refund of unused fees at the end of an eligibility period, forfeiture of the fee for a missed or late appointment, and a new fee for each retest. Prometric's optional practice tests are priced separately at $7 to $10 each with 'super pack versions available for $25'. Credentia's Alabama fee table is not reported here, and the reason is a defect in the document rather than a gap in the search: its Alabama candidate handbook introduces the table with the sentence 'The fees listed below have been established for the NNAAP Examination in South Carolina', carries two different effective dates for the same table ('effective as of July 1, 2020' in the text, 'Effective 9/1/20' in the table header), and sets out rows whose labels do not line up with a nurse aide fee schedule. A figure taken from that table would be a figure taken from another state's schedule, so none is taken. A candidate testing with Credentia should get the current fee from Credentia's Alabama test-taker page, https://credentia.com/test-takers/al. Note that ADPH's Nurse Aide Training Program handbook prints this provider's address as 'www.getcredentia.com', and that address did not load when checked on 2026-08-16. Federal rule that overrides all of this for employed aides: 42 C.F.R. 483.152(c)(1) — 'No nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide training and competency evaluation program may be charged for any portion of the program (including any fees for textbooks or other required course materials)', and 483.152(c)(2) requires the State to provide for pro-rata reimbursement of program costs where the individual is hired within 12 months of finishing. Training cost is set by the approved program and is not published by ADPH.",
   "legal_basis": "[{\"citation\": \"Ala. Admin. Code r. 420-5-10-.01 (Nursing Facilities — Definitions), Alabama State Board of Health / Alabama Department of Public Health\", \"what_it_governs\": \"Defines 'Nurse Aide' as 'Any individual providing nursing related services to residents in a facility who is not a licensed health professional, a registered dietitian, or someone who volunteers to provide such services without pay', and creates the 'Training and Abuse Registry' — both the requirement that ADPH maintain findings of abuse, neglect or misappropriation with the individual's disputing statement and a right to notice and a hearing, and the rule that 'the names and addresses of all nurse aides who attended an approved training program and who have successfully passed the approved competency evaluation will be included on the registry', with the pre-July-1-1989 grandfather exception.\", \"url\": \"https://admincode.legislature.state.al.us/administrative-code/420-5-10\"}, {\"citation\": \"Ala. Admin. Code r. 420-5-10-.03 (Nursing Facilities — Administrative Management), paragraphs (8) through (16); rule history: repealed and replaced eff. Aug. 23, 1996, amended eff. Dec. 23, 1999, Oct. 23, 2003, July 28, 2004 and July 30, 2016\", \"what_it_governs\": \"The operative nurse aide rules: the four-month limit on using an untrained nurse aide, the bar on using non-permanent staff who do not meet the same conditions, the registry-verification duty before an aide may serve, the multi-state registry inquiry duty, the 24-month required-retraining trigger, the annual performance review and the in-service floor of 'no less than 12 hours per year', and the facility's duty to ensure nurse aides can demonstrate competency.\", \"url\": \"https://admincode.legislature.state.al.us/administrative-code/420-5-10\"}, {\"citation\": \"Ala. Admin. Code ch. 420-5-10 (Nursing Facilities), statutory authority 'Code of Ala. 1975, §§22-21-20, et seq.'\", \"what_it_governs\": \"The whole ADPH nursing facility chapter within which Alabama's nurse aide requirements sit — eighteen rules from Definitions through Physical Plant, including the feeding assistant scheme at r. 420-5-10-.12. The chapter states its own authority as Code of Ala. 1975, §§22-21-20 et seq.; the text of those Code sections was not read as of August 16, 2026, and nothing on this page is quoted from them.\", \"url\": \"https://admincode.legislature.state.al.us/administrative-code/420-5-10\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal floor Alabama's programme requirements are built on and which ADPH's own Nurse Aide Training Program handbook reproduces: 'Consist of no less than 75 clock hours of training', the subject list, 'at least 16 hours of supervised practical training', the supervision conditions, and the prohibition of charges at 483.152(c) — no nurse aide employed by or holding an offer from a facility when the programme begins 'may be charged for any portion of the program', with pro-rata reimbursement where employment follows within 12 months.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"42 C.F.R. part 483, subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants), including 483.150 and 483.156\", \"what_it_governs\": \"The federal frame requiring every state to run a nurse aide registry and to approve training and competency evaluation programmes, and the conditions on which a state may approve a programme offered by a facility. Alabama's registry exists under this subpart; the specific section texts other than 483.152 were not read as of August 16, 2026.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Two, and the training program picks. ADPH's Nurse Aide Training Program handbook: 'CERTIFICATION TEST PROVIDERS — Nurse Aide Training Programs may choose one of the following test providers for Certified Nurse Aide Examination. Prometric ... Credentia.' Both confirm the arrangement from their own side. Prometric: 'The Alabama Department of Public Health (ADPA) has approved Prometric to administer its Certified Nurse Aide (CNA) Exam in nursing homes or qualified facilities in the state of Alabama' (the misspelling of the agency's initials is Prometric's). Credentia: 'The Alabama Department of Health has contracted with Credentia... Credentia will develop, schedule, administer, score, and report the results of the NNAAP Examination required for certification and placement on the Alabama Nurse Aide Registry.' The Credentia examination is the National Nurse Aide Assessment Program (NNAAP), which its handbook describes as 'developed by the National Council of State Boards of Nursing, Inc., (NCSBN) to meet the nurse aide evaluation requirement of federal and state laws and regulations'; ADPH's own handbook contains an 'EQUIPMENT LIST FOR NNAAP SKILLS EVALUATION', so the state builds the NNAAP into its program-approval paperwork. A third name still appears on the state's own page and is recorded rather than resolved: the ADPH registry FAQ tells nursing students to 'contact NACES at 1-877-889-0939 to get an application and handbook to apply to take the test', while ADPH's Nurse Aide Training Program handbook names only Prometric and Credentia. Both are ADPH publications and they do not agree; this page states both and follows the handbook, which is the document ADPH gives to training programs.",
   "training_hours": "75 clock hours minimum in total, and Alabama splits the practical part in two: at least 16 clinical hours and at least 16 lab hours. ADPH's Nurse Aide Training Program handbook states the standard a program must meet — 'Consist of no less than 75 clock hours of training (total)', 'Include at least the subjects specified in paragraph (B) of this section', and 'Include at least 16 hours of supervised practical training (clinical training) and 16 hours of lab training' — and its own application checklist repeats the arithmetic a program must report: classroom hours, lab hours, clinical hours, and 'Total hours (Must be at least 75 hours with 16 hours being clinical hours)'. The lab hours are the Alabama-specific part. The federal rule ADPH is restating, 42 C.F.R. 483.152(a), requires only '(1) Consist of no less than 75 clock hours of training' and '(3) Include at least 16 hours of supervised practical training. Supervised practical training means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse' — one 16-hour bucket that a laboratory can satisfy. ADPH's handbook asks for 16 hours of clinical training in a nursing home and 16 hours of lab training, and its checklist requires the applying program to name 'the Nursing Home (Long-Term Care Facility) where the clinical practice will be conducted (16 hours)'. The first 16 hours are front-loaded: 'At least a total of 16 hours of training in the following areas prior to any direct contact with a resident: Communication and interpersonal skills; Infection control; Safety/emergency procedures including the Heimlich maneuver; Promoting residents' independence; Respecting residents' rights.' The remaining curriculum ADPH requires covers basic nursing skills (vital signs, height and weight, caring for the resident's environment, recognising and reporting abnormal changes, care when death is imminent), personal care skills, and the further subject areas in the handbook's integrated lesson plan. Where the figure comes from matters here: ADPH's administrative rules do not state a nurse aide hour figure at all — Ala. Admin. Code ch. 420-5-10 was read section by section and its only nurse aide numbers are the four-month pre-listing window, the 24-month retraining trigger and the 12 in-service hours a year. The 75/16/16 figures are ADPH's, published in its Nurse Aide Training Program handbook.",
   "lapse_rule": "Twenty-four months without qualifying paid work ends the listing, and the way back is the whole course again plus both tests — Alabama publishes no retest-only route. ADPH: 'How can I get my certification reactivated if I have not worked as a CNA for over 24 months? You must complete a Nurse Aide Training program (retrained) and take the certification test (retested) to be eligible to work in a nursing home.' The state rule says the same thing in regulatory language: 'Required retraining. If, since an individual's most recent completion of a training and competency evaluation program, there has been a continuous period of 24 consecutive months during none of which the individual provided nursing related services for monetary compensation, the individual must complete a new training and competency evaluation program' (Ala. Admin. Code r. 420-5-10-.03(14)). Credentia's Alabama handbook lists it as a distinct eligibility route on the same terms — 'LAPSED NURSING ASSISTANT: You were previously certified in the state of Alabama, but your certification expired. You must successfully complete a state approved nurse aide training program and retest both portions of the examination' — and states the federal basis: 'Under federal requirements, certification as a nurse aide becomes invalid after a lapse of twenty-four (24) consecutive months or more in the performance of paid nursing-related services.' A separate and harsher outcome is the abuse finding, which is not a lapse at all. The registry is defined in rule as a 'Training and Abuse Registry' and ADPH must record 'specific documented findings by the Alabama Department of Public Health of resident neglect or abuse or misappropriation of resident property by any individual used by a nursing facility, as well as any brief statement of the individual disputing the findings'; anyone disclosing such a finding must also disclose the aide's statement or an accurate summary of it, and 'Individuals must be notified in writing prior to the inclusion of findings in the registry and allowed the opportunity for a hearing in the event the individual disputes the findings' (r. 420-5-10-.01(uu)(i)). ADPH publishes the resulting abuse list as a document on the registry site. 'Good standing', in ADPH's own definition, 'means a person is on the registry and their certification has no substantiated adverse finding of abuse.'",
   "reciprocity": "Alabama has no reciprocity application and no reciprocity form — the employer starts the process, not the aide. ADPH: 'Does Alabama have a Reciprocity form? No. The reciprocity process for the state of Alabama requires your employer contact the State agency to have your name placed on the Alabama Nurse Aide Registry.' The route in full, in ADPH's words: 'The only way you can get on the Alabama CNA Registry from another state is to apply for a job at a nursing home. Once hired by one of the entities in #4 above, your certification must be verified and placement made on the Alabama Nurse Aide Registry. You must have an active certification in the state you are transferring from with no validated allegations of abuse against you.' The limit most transferring aides hit: 'If you want to do home health work and not work in a nursing home, the CNA Registry cannot transfer you. The only other way to get on the Alabama Registry is for you to take an approved CNA program with clinicals and pass the state/federal tests (both written and skills).' The bar on transferring a finding is stated separately: 'An individual listed on another state's Nurse Aide Registry with validated findings of resident abuse, resident neglect, or misappropriation of resident property in a nursing home may not be employed as a nurse aide in Alabama nursing facilities.' Returning Alabama aides are treated differently and more generously: 'What is the reciprocity process if I originally received my certification in Alabama, went to another state, got on their registry, and have now returned to Alabama? As long as the individual is on another state's registry (current/active and in good standing), their status is active in the state of Alabama. Information regarding an individual's status is shared state to state.' For aides leaving Alabama, Credentia's Alabama handbook directs the question outward — to 'Obtain information regarding endorsement to other states (call the state to which you want to transfer).' No ADPH source we checked states a fee, a deadline or a processing time for any of this.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Alabama Certified Nurse Aide Registry — Frequently Asked Questions (Alabama Department of Public Health). The single richest state source behind this page. Establishes 'Good Standing means a person is on the registry and their certification has no substantiated adverse finding of abuse'; 'No, there is no renewal process for the Alabama Nurse Aide registry'; the active-status definition and the 24-month extension beyond the last date worked; 'You must work at least 8 hours every 24 months in a nursing home, hospital, home health agency, hospice agency, or mental health facility for paid compensation. Volunteer work does not count. Private sitting, assisted living facilities, and doctor's office work does not count'; 'Your Social Security number is your certification number'; 'Any individual successfully completing the state approved nurse aide competency and evaluation and training program desiring to work as a nurse aide in an Alabama nursing home must first be listed in good standing on the Alabama nurse aide registry'; the three-attempt and 24-month testing rule; 'Program certificates are obtained from the program that the CNA completed'; 'Do CEU's keep a certification active? No'; the retrain-and-retest reactivation rule; 'Does Alabama have a Reciprocity form? No'; the employer-driven transfer process and the home-health limit; the CNA instructor qualifications; the SSN-based public lookup and the (334) 206-5169 staff-assisted verification; and the October 2006 system change behind incomplete older records.\", \"url\": \"https://dph1.adph.state.al.us/NurseAideRegistry/FAQ.aspx\"}, {\"label\": \"Alabama Nurse Aide Training Program handbook (Alabama Department of Public Health, Bureau of Health Provider Standards), 27 pages. Establishes the two approved test providers — 'Nurse Aide Training Programs may choose one of the following test providers for Certified Nurse Aide Examination. Prometric ... Credentia'; the training standard 'Consist of no less than 75 clock hours of training (total)' and 'Include at least 16 hours of supervised practical training (clinical training) and 16 hours of lab training'; the checklist line 'Total hours (Must be at least 75 hours with 16 hours being clinical hours)'; the nursing home clinical requirement '(16 hours)'; the 16 pre-contact hours and their five subject areas; the instructor and program-coordinator qualifications and the four adult-teaching routes; the private school license, business license and mailed application packet; the immunisation, TB and Hepatitis B file duty; and the equipment list for the NNAAP skills evaluation.\", \"url\": \"https://dph1.adph.state.al.us/NurseAideRegistry/NurseAideTrainingGuide.pdf\"}, {\"label\": \"Alabama Certified Nurse Aide Registry — public search (Alabama Department of Public Health). The lookup itself: 'Search the Alabama Certified Nurse Aide Registry to verify the status of a Nurse Aide' with a single Social Security Number field, plus links to the abuse list document, the FAQ, the contacts page and the training program guide.\", \"url\": \"https://dph1.adph.state.al.us/NurseAideRegistry/\"}, {\"label\": \"Alabama Certified Nurse Aide Registry — Contacts (Alabama Department of Public Health). Establishes the operator and address: 'Alabama Certified Nurse Aide Registry, Alabama Department of Public Health, Division of Health Care Facilities, The RSA Tower, Suite 700, 201 Monroe Street, Montgomery, AL 36104', phone (334) 206-5169, fax (334) 206-0361, and a named Nurse Aide Registry Coordinator.\", \"url\": \"https://dph1.adph.state.al.us/NurseAideRegistry/Contacts.aspx\"}, {\"label\": \"Alabama Department of Public Health — Health Provider Standards (Bureau home page). Establishes that 'The Bureau of Health Provider Standards is Alabama's regulatory agency responsible for licensing and/or certifying health care facilities. The bureau consists of the Division of Health Care Facilities and the Provider Services Unit', and links the 'Alabama Certified Nurse Aide Registry' from the Health Care Facilities section — the connection between the public ADPH site and the registry application.\", \"url\": \"https://www.alabamapublichealth.gov/providerstandards/index.html\"}, {\"label\": \"Alabama Department of Public Health — Facilities Questions. Repeats the pointer: 'Q: How do I obtain information on the Alabama Certified Nurse Aide Registry? A: Visit the Alabama Certified Nurse Aide Registry.'\", \"url\": \"https://www.alabamapublichealth.gov/providerstandards/faq.html\"}, {\"label\": \"Alabama Administrative Code chapter 420-5-10 (Nursing Facilities), Alabama Legislative Services Agency. The official current text of the eighteen rules, including r. 420-5-10-.01 (definitions of nurse aide and of the Training and Abuse Registry), r. 420-5-10-.03(8)-(16) (the four-month rule, registry verification, multi-state inquiry, 24-month retraining and the 12-hour annual in-service floor) and r. 420-5-10-.12 (feeding assistants, 9 hours).\", \"url\": \"https://admincode.legislature.state.al.us/administrative-code/420-5-10\"}, {\"label\": \"Alabama Department of Public Health — Health Care Facilities Rules. The agency's own list of its rule chapters with links to the current Alabama Administrative Code, including chapter 420-5-10 for nursing facilities.\", \"url\": \"https://www.alabamapublichealth.gov/providerstandards/rules.html\"}, {\"label\": \"Prometric — Alabama Nurse Aide Exam. The state-approved test provider's Alabama page, named in ADPH's own Nurse Aide Training Program handbook. Establishes 'The Alabama Department of Public Health (ADPA) has approved Prometric to administer its Certified Nurse Aide (CNA) Exam in nursing homes or qualified facilities in the state of Alabama', and links the Alabama candidate information bulletin, the clinical skills checklist, the clinical skills instructions and timing information, the indirect care behaviours list and the measurement forms.\", \"url\": \"https://www.prometric.com/exams/nurseaide-al/\"}, {\"label\": \"Alabama Nurse Aide candidate information bulletin (Prometric). Establishes the Prometric fee schedule 'Clinical Skills Test $45; Knowledge (written or oral) Test $40; Test Site Administration Fee $40'; 'Test fees are nonrefundable and nontransferable'; the payment methods and the exclusion of personal cheques and cash; 'The Written Test consists of 55 multiple-choice questions. You will have 90 minutes to take the test'; the five-skill clinical test and the 31-to-40-minute range; 'To pass the Clinical Skills Test, you must pass all five skills'; 'Testing must be completed within two years of your training completion date. You are allowed three attempts'; the same-eligibility-period rule; the retest and same-day retake policy; and the 30-minute early arrival and identification requirements.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/AL-NA-CIB.pdf\"}, {\"label\": \"Alabama Nurse Aide Written (or Oral) Examination & Skills Evaluation Candidate Handbook, January 2024 (Credentia), the other test provider named in ADPH's handbook. Establishes 'The Alabama Department of Health has contracted with Credentia... Credentia will develop, schedule, administer, score, and report the results of the NNAAP Examination required for certification and placement on the Alabama Nurse Aide Registry'; the NNAAP structure (70 written multiple-choice questions; an oral alternative of 60 multiple-choice plus 10 reading comprehension questions, in English or Spanish; five randomly selected skills in thirty minutes, all five to be performed correctly); the four eligibility routes including the lapsed-aide route; 'Alabama does NOT approve any on-line CNA programs'; the two-year testing deadline; 'Alabama does NOT issue certificates or licenses to nurse aides. The only official document you will receive is the Score Report given to you at the test center'; the lapsed-certification and re-certification statements; and the 30-day grievance process. Its fee table is not used — see fees.\", \"url\": \"https://credentia.com/storage/al-handbook_2024.pdf\"}, {\"label\": \"Credentia — Alabama test takers page. The provider's live Alabama landing page, carrying the Alabama candidate handbook, the Alabama skill listing, regional test site details, the online-proctored written and oral exam option, the voucher order form, the grievance route and a link to search the Alabama nurse aide registry.\", \"url\": \"https://credentia.com/test-takers/al\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR current text). The federal programme-approval rule ADPH's handbook reproduces, including the 75-clock-hour floor, the 16 hours of supervised practical training and its laboratory definition, and the prohibition of charges to employed nurse aides with pro-rata reimbursement within 12 months.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/al-cna/"
  },
  {
   "page_id": "ar-cna",
   "state": "Arkansas",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Arkansas Department of Human Services (DHS) — Division of Provider Services and Quality Assurance, Long-Term Care Facility Nursing Assistant Training Program and Certified Nursing Assistant Registry",
   "board_url": "https://humanservices.arkansas.gov/divisions-shared-services/provider-services-quality-assurance/occupational-licensing/cna-nha-training-program/",
   "application_url": "https://ar.tmutest.com/apply",
   "renewal_cycle": "Every 24 months, and the work test is eight hours. The rule: 'The initial certification period is valid for twenty-four (24) months. Each certificate contains an expiration date... The renewal process will require the nursing assistant to document having worked as a nursing assistant for monetary compensation during the prior two (2) years. This provision shall be defined by at least one (1) documented day (meaning, eight (8) hours) of employment providing nursing or nursing-related services for monetary compensation in any setting.' Note 'in any setting' — Arkansas does not restrict the qualifying work to nursing homes. The contractor's handbook states the same test as 'at least eight (8) consecutive hours during the previous 24 months.' How it is filed: online, by the aide, with employer verification. 'Each certified nursing assistant shall be responsible for renewing their certification online approximately sixty (60) calendar days before the expiration of their certification', and certifications 'may not be renewed more than sixty (60) calendar days prior to the expiration date.' In the system, 'sign in to your TMU account... and record your work hours and the location where you were employed. An email verification link will be sent to the employer contact you choose from the list of employers. When the employer verifies your work experience, your eligibility will be extended an additional 24 months.' Reminders go out 60 days ahead 'via email and text message. No renewal certifications are sent via USPS mail.' Private-duty aides have a special proof: 'Certified Nursing Assistants who provide services for private pay clients must include a check stub and a notarized letter from the employer, which should include Certified Nursing Assistant duties performed within the twenty-four-month period.' When the aide is not currently working: 'Nursing assistants who are currently employed as a nursing assistant at the time of their renewal will be renewed for twenty-four (24) months. Nursing assistants who are not currently employed will be renewed for twenty-four (24) months beginning with the last day employed as a nursing assistant' — so an unemployed aide's new term is back-dated to the last day worked rather than starting fresh. Who cannot renew: aides on the employment clearance registry with a disqualification for a substantiated finding of abuse, neglect or misappropriation, or a disqualifying criminal record under Arkansas Code § 20-38-101 et seq.; and 'Failure to fully complete the renewal or provide false or inaccurate information shall constitute the basis for denial of certification renewal.' Nothing in the renewal is a fee.",
   "ce_hours": "No continuing education is required of the aide to renew — the renewal test is work, not education. What Arkansas requires instead is an in-service duty on the facility, and it is monthly rather than annual: 'All facilities will continue to provide ongoing in-service training on a routine basis both in groups and as necessary in specific situations on a one-to-one basis. Each nursing assistant must receive one (1) hour of in-service training per month.' The facility must also 'complete a performance review of each nursing assistant at least once per year and provide regular in-service training based on the outcome of these reviews', addressing 'areas of weakness' and 'be sufficient to ensure the continuing competence of the nursing assistants', plus 'the special needs of residents as determined by each facility'. In-service may be delivered on the unit 'as long as it is directed toward skills improvement, provided by appropriately trained staff, and documented (for example, skills demonstration with return demonstration recorded on a check list).' A named, encouraged-but-not-mandatory topic: 'Effective July 1, 2006, facilities are strongly encouraged to offer in-service training for nursing-home-employed Certified Nursing Assistants who were certified in Arkansas prior to July 1, 2006, that covers the Barbara Broyles Alzheimer and Dementia Training that is included in Arkansas LTCF Nursing Assistant Training Curriculum', and the same training is 'strongly encouraged' for aides who came in by reciprocity or by challenging the examination. The one place continuing education is named as a renewal condition is the military and out-of-state provisions, which speak of extending 'any continuing education requirements' for a deployed service member or spouse by 180 days, and require a person granted automatic occupational licensure to meet 'all renewal requirements of the occupational licensure, including without limitation a criminal background check and continuing education hours.' Those clauses are drafted from a general occupational-licensing template; no continuing education hour figure for nurse aides appears anywhere in the rules, the curriculum or the candidate handbook, and the renewal process the state actually operates asks only for eight hours of paid work.",
   "exam": "Two parts — a knowledge test and a skills demonstration — and both must be passed. The rule: 'The competency examination shall consist of two (2) components, a written (or oral) examination and a skills demonstration. Each examination candidate will be allowed to choose between a written or oral examination. The oral examination will be read from a prepared text in a neutral manner.' Knowledge test, from the current candidate handbook: 'You will have a maximum of 60 minutes to complete the 75-question knowledge exam. The multiple-choice questions will be presented to you, one at a time, on the computer screen to select answers A, B, C, or D... You must have a score of 76% or better to pass the knowledge exam.' A Spanish version and an audio (oral) version are offered, the audio version must be requested before the testing fee is paid, and it is delivered through wired earbuds — 'Bluetooth-connected devices are not allowed.' A remotely proctored knowledge exam is available. Language support and its limits: the rules provide that 'The examination will be in English. Translation of this examination will be offered, if needed', and set a strict condition on paper dictionaries — 'Foreign language translation dictionaries must be shown to the registered nurse test observer at check-in and to the Knowledge Test Proctor when entering the knowledge test room. No electronic dictionaries are allowed. No definitions or instances of writing are allowed in the translation dictionary. If there are any definitions or instances of writing, the translation dictionary will not be permitted to be used during testing.' Skills test — and here the rule and the current handbook disagree, so both are given. The rules say 'The skills demonstration shall consist of five (5) randomly selected questions drawn from a pool of tasks ranked based on the level of difficulty.' The candidate handbook in force from 1 July 2026 says the candidate performs three or four: 'Each of your randomly selected 3 or 4 tasks will have scenarios associated with them... You will be allowed a maximum of 30 minutes to complete your three or four tasks. After 15 minutes have elapsed, you will be alerted that 15 minutes remain.' The scoring standard is the handbook's: 'You must correctly perform all key steps (in bold font) and 80% of all steps on each assigned task to pass the Skill Test.' The skills test runs 'in a facility (not disqualified by criteria specified in Section V, item B.) or laboratory setting' with an RN test observer. Attempts and the clock: 'All candidates will be allowed up to three (3) attempts, within a twelve month period, to successfully complete all portions of the competency examination. Failure after three (3) attempts will require retraining in order to qualify to sit for the competency examination. An individual has twelve (12) months to successfully pass the test after retraining.' A trainee employed by a long-term care facility who fails three times 'is prohibited from providing nursing services to residents in a long-term care facility', though employment may be kept by re-enrolling — completing the first 16 hours again before any direct resident contact and taking only duties already deemed competent while working through the remaining 90 hours. A test review may be requested for a $25 non-refundable deposit, refunded only 'If, after investigation, the review finding is in your favor.'",
   "fees": "Arkansas charges no state fee for the certificate, and says so on its own page and in its own rule: 'The Department of Human Services does not require an initial fee for this occupational license; however, there is a fee to take the state examination. The amount of the examination fee will be announced in a timely manner by the Department of Human Services or designated contractor.' The rules add a conditional waiver in case a fee is ever introduced — per Arkansas Code Annotated § 17-5-104, an initial fee would not be charged to a person receiving Arkansas Medicaid, SNAP, WIC, TANF or Lifeline assistance, a person approved for unemployment within the last twelve months, or a person whose income does not exceed 200% of the federal poverty guidelines — with the express carve-out that 'The waiver of the initial fee does not include fees for: a criminal background check; an examination or a test; or a medical or drug test.' Examination fees, paid to the contractor and current from 1 July 2026: 'Knowledge Exam or Retake $30.00; Knowledge Exam - Spanish Version or Retake $30.00; Audio Version of Knowledge Exam -or- Audio Knowledge Retake $40.00; Audio Spanish Version of Knowledge Exam or Retake Spanish Version $40.00; Skill Test or Retake $95.00.' Testing fees must be paid before a test date can be scheduled. Refunds: a request must be made within 30 days of payment and by a published deadline before the exam, on the contractor's own form and never by telephone, and a qualifying refund is 'a full refund of any testing fees paid minus a $35 refund processing fee.' A test review costs a '$25 non-refundable test review request deposit', returned only if the review goes the candidate's way. Who pays the exam fee is the point most candidates miss: 'The Department of Human Services will be responsible for paying the examination fee one (1) time for individuals who are employed by a Medicaid certified long-term nursing facility or those individuals that have a commitment (\"letter of intent\") to be employed in a Medicaid certified nursing facility. Letters of intent to hire from Medicaid certified nursing facilities must be dated within twelve (12) months immediately preceding the date of the application to take the examination. Independent examination candidates who are taking the competency examination without an employment connection to a long-term care facility will be responsible to pay their own examination fee.' The federal rule sits behind that: 'In accordance with 42 C.F.R. § 483.154, no nurse aide who is employed by, or who has received an offer of employment from, a facility on the date on which the aide begins a nurse aide competency examination program may be charged for any portion of the program', with pro-rata reimbursement where employment follows within twelve months. A reciprocity processing fee exists but its amount is not published — the Out-of-State Reciprocity Form 9110AR is filled online and submitted with a processing fee, and neither the DHS pages, the rules nor the candidate handbook states the figure.",
   "legal_basis": "[{\"citation\": \"Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program, Arkansas Department of Human Services, Agency #016.06, adopted 1992, revised July 1, 2024\", \"what_it_governs\": \"The whole Arkansas nurse aide scheme: the 90-hour training requirement and its Part I / Parts II-III structure, virtual training, instructor qualifications and the 24:1 and 12:1 ratios, programme approval and withdrawal, the competency examination and its two components, the three-attempt limit and the twelve-month clock, examination fees and who pays them, candidate qualifications and exclusions, military and out-of-state licensure, the CNA registry and its merger with the long-term care facility employment clearance registry, the inquiry process, 24-month certification renewal on eight documented hours of paid work, the petition to remove a neglect finding, compliance monitoring and facility reimbursement.\", \"url\": \"https://humanservices.arkansas.gov/wp-content/uploads/Rules-for-the-AR-LTCF-NA-Training-Program-07012024.pdf\"}, {\"citation\": \"20 CAR Part 403 (Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program), Code of Arkansas Rules, Title 20, Chapter X, Subchapter A\", \"what_it_governs\": \"The codified version of the same rules. The Code of Arkansas Rules 'is a codification of the general and permanent rules of Arkansas agencies' under Arkansas Code § 25-15-218 and 'constitutes the official version', effective January 1, 2025 and updated weekly. Part 403's codification note records the authority as Arkansas Code § 20-10-701 et seq. and the federal mandate of Public Law 100-203 (the Nursing Home Reform Act, Subtitle C of OBRA 1987) with the technical amendments of 1989 and 1990, implemented through sections 1819(a)-(f) and 1919(a)-(f) of the Social Security Act.\", \"url\": \"https://codeofarrules.arkansas.gov/Rules/Rule?levelType=part&titleID=20&chapterID=38&subChapterID=50&partID=1157&subPartID=&sectionID=\"}, {\"citation\": \"20 CAR § 403-201 (General rule), authority Arkansas Code § 20-10-705\", \"what_it_governs\": \"The four-month rule in its codified form: 'A facility must not use any individual working in the facility as a nursing assistant for more than four (4) months (meaning one hundred twenty (120) calendar days) unless that individual has successfully completed a training program and competency examination approved by the Department of Human Services as required by the Centers for Medicare and Medicaid Services.'\", \"url\": \"https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=20&chapterID=38&subChapterID=50&partID=1157&subPartID=6850&sectionID=44415\"}, {\"citation\": \"Arkansas Code Annotated § 17-5-104 (initial licensure fee waiver), § 17-4-101 et seq. (uniformed service members, veterans and spouses), § 17-7-101 et seq. (automatic occupational licensure), § 17-3-102 (disqualifying criminal offences) and § 20-38-101 et seq. (long-term care facility employment clearance)\", \"what_it_governs\": \"The general Arkansas occupational-licensing statutes the nurse aide rules apply: the income- and benefit-based waiver of an initial licensure fee, the military and military-spouse expedited routes, the automatic-licensure route for out-of-state practitioners, the criminal-offence disqualifications and the employment clearance registry bar. Their statutory texts were not read as of August 16, 2026; each is cited as the rules cite it, and nothing is quoted from the statutes themselves.\", \"url\": \"https://humanservices.arkansas.gov/wp-content/uploads/Rules-for-the-AR-LTCF-NA-Training-Program-07012024.pdf\"}, {\"citation\": \"42 C.F.R. 483.152 and 42 C.F.R. 483.154, as applied by the Arkansas rules\", \"what_it_governs\": \"The federal training-programme standard the Arkansas 90-hour requirement is written on top of ('Pursuant to 42 C.F.R. § 483.152, a nurse aide training and competency examination program must include, at a minimum, a combination of classroom (in-person or virtual) and clinical instruction'), and the prohibition on charging an employed nurse aide for any portion of a competency examination programme, with pro-rata reimbursement where employment follows within twelve months.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"42 U.S.C. § 1395i-3(g)(1)(D), as applied by the Arkansas rules\", \"what_it_governs\": \"The federal basis for the petition to remove a substantiated finding of neglect from the registry — the process Arkansas operates, and the reason no equivalent petition exists for physical abuse, verbal abuse or misappropriation of resident property.\", \"url\": \"https://humanservices.arkansas.gov/wp-content/uploads/Rules-for-the-AR-LTCF-NA-Training-Program-07012024.pdf\"}]",
   "exam_vendor": "D&S Diversified Technologies LLP / Headmaster LLP (D&SDT-HEADMASTER), under contract to the Arkansas Department of Human Services, testing through its TestMaster Universe system. The rule keeps the duty with the state and allows the delegation: 'The Department of Human Services or its appointed agency shall be responsible for administering the competency examination.' The candidate handbook names the arrangement from the other side: 'The Arkansas Department of Human Services (DHS) approved D&S Diversified Technologies (D&SDT)-HEADMASTER, LLP to provide tests and scoring services for nurse aide testing.' DHS's own CNA Training Program page carries the contractor's contact block — Arkansas Program Manager, PO Box 6609, Helena, MT 59604, testing 888-401-0462, registry 888-401-0465, fax 406-442-3357 — and links its Arkansas page directly. The same contractor runs the registry, not just the exam: its Arkansas page is headed 'Arkansas Nurse Aide Testing, Certification and Registry Services', and renewals, reciprocity applications, demographic changes and the public registry search all run through the same system. Arkansas does not use the NNAAP examination; the state's own curriculum guide is the examination blueprint. Skills tests are proctored locally: 'The skills demonstration will be administered and evaluated by a registered nurse (RN) with at least one (1) year experience in providing care for the elderly or chronically ill', and may be run 'by facility or training site personnel (RNs as described above) if secure, standardized, and scored by the contractor approved by the Department of Human Services.'",
   "training_hours": "90 hours total. The rules state the total three times and never in fewer words than this: 'The requirement for state certification shall include a minimum of ninety (90) hours of training which consist of no less than seventy-four (74) clock hours of training, including sixteen (16) hours of supervised practical training, for a total of ninety (90) hours.' How the 90 divides is stated two different ways in the same document, and both are recorded here rather than reconciled. (a) the programme structure: Part I is 'a minimum of sixteen (16) hours initial classroom (in-person or virtual) instruction... This will include both theory instruction and skills demonstration in the classroom lab. During Part I, the trainee is not allowed on the floor', and then 'Parts II and III require the completion of the remaining seventy-four (74) clock hours of training consisting of theory, classroom lab, and clinical skills training. Clinical skills training must include at least sixteen (16) hours of supervised practical training in a facility, performing tasks on an individual under the direct supervision of the instructor.' On that reading 16 + 74 = 90, and the 16 supervised practical hours sit inside the 74. (b) the historical description, in the same rules: 'These ninety (90) hours consisted of seventy-four (74) hours of \"formal\" classroom training course, as well as sixteen (16) hours of supervised practical training', and again in the home health aide eligibility route, 'a minimum of seventy-four (74) hours classroom training, and sixteen (16) hours of supervised practical training.' On that reading 74 + 16 = 90 and the 16 practical hours sit outside the classroom total. The two readings put the same 90 hours in different boxes, and the sentence quoted at the top of this section contains both ('no less than 74... including 16... for a total of 90'). What is certain and repeated everywhere is 90 total, at least 16 hours of supervised practical training in a facility, and 16 hours of classroom before any floor work. The federal floor is 75, so Arkansas sits 15 hours above it, and the rules say they are building on it: 'Pursuant to 42 C.F.R. § 483.152, a nurse aide training and competency examination program must include, at a minimum, a combination of classroom (in-person or virtual) and clinical instruction.' The curriculum itself is a separate published document, the Arkansas Long Term Care Facility Nursing Assistant Training Curriculum, and the examination is built from it.",
   "lapse_rule": "Miss the eight hours and the listing goes inactive; go past twenty-four months and the only way back is the examination again, plus sixteen hours of clinical training. The rule: 'The registry shall make \"inactive\" those individuals who cannot document having worked in an aide capacity within a twenty-four (24) month period.' Then: 'A certification that has been expired for a period longer than twenty-four (24) months cannot be renewed and the individual shall retest and complete sixteen (16) hours of clinical training to re-certify to an active status.' And separately: 'An individual will be required to successfully complete a new competency evaluation test to become recertified... if documentation of having worked in an aide capacity within the previous twenty-four (24) month period cannot be provided, or for any certification that has been expired for over twenty-four (24) months.' Retesting is not automatic — 'Permission for retesting shall require an \"admission slip\" obtained from the examination agency prior to the specified examination date.' The contractor states the same rule as a federal one: 'Under federal regulations, a nurse aide becomes ineligible for employment if they do not perform at least 8 hours of nursing-related services for pay in a health care setting during a period of 24 consecutive months. To reestablish employment eligibility on the ARNAR, you must successfully pass both components of the approved Arkansas Nurse Aide Competency Examination.' A misconduct finding is a different and harder outcome. DHS 'shall review and investigate allegations of neglect, abuse, or misappropriation of resident property by a nursing assistant. A nursing assistant shall be given written notice by the Department of Human Services of a finding on an allegation and must request, in writing, a formal hearing within thirty (30) days of receipt of the notice, or the right to a hearing shall be waived.' A substantiated finding — by failure to appeal or by final administrative order — goes on the registry together with 'any brief statement of the individual disputing the findings', and on any inquiry DHS 'shall disclose any information concerning a finding of resident neglect, resident abuse, or misappropriation of resident property' plus the aide's statement or an accurate summary of it. Aides carrying such a finding may neither renew nor test. One narrow route out exists, and only for neglect: under 42 U.S.C. § 1395i-3(g)(1)(D) DHS operates a petition to remove a substantiated neglect finding — 'There shall not be a petition process available for substantiated findings of physical abuse, verbal abuse, or misappropriation of resident property' — and it turns on DHS determining that the petitioner's employment and personal record shows no pattern of abusive behaviour or neglect, considering among other things whether the neglect 'was a singular occurrence as identified in the incident investigation file', whether there is a criminal conviction related to neglect, abusive behaviour or physical violence, and whether the petitioner appears on the Adult and Long-Term Care Facility Resident Maltreatment Central Registry. 'Individuals approved for removal of a neglect finding... shall be eligible to renew their certification.'",
   "reciprocity": "Arkansas runs a registry-to-registry reciprocity, and it is filed with the contractor rather than with DHS. The threshold is unconditional: 'In any case, you must be current and in good standing on a nurse aide registry in a state other than Arkansas to be considered.' The filing is 'the Out-of-State Reciprocity Form 9110AR, which can be found on the Arkansas TMU main page (before logging in to your TMU account) under APPLICATIONS', submitted with a processing fee and supporting documents; staff then 'determine if you are eligible to be added to the Arkansas Nurse Aide Registry.' No Arkansas exam where the out-of-state exam matches: 'If you have successfully passed a nurse aide competency exam that is the same or substantially similar to the Arkansas competency examination within one (1) year of completing your training program, your name may be placed on the ARNAR.' The contractor's Arkansas page adds a condition worth knowing before filing: form 9110AR is for someone who 'MUST NOT be currently listed on the AR NA registry'; an aide already on the Arkansas registry but working out of state uses the different form 9110AR-REN, 'Out of State Employment Verification for AR Registry Renewal'. Where the exam is not comparable, reciprocity becomes a training waiver plus a test: a candidate 'who has completed a training program of at least 90 hours but ha[s] not successfully completed a nurse aide competency exam that is the same or substantially similar to the Arkansas examination' files the Out-of-State Training Waiver Application and must pass the Arkansas examination 'within one (1) year of your documented completion of comparable training', on the ordinary three-attempt allowance. A separate statutory route also exists: under Arkansas Code Annotated § 17-7-101 et seq., automatic occupational licensure is available to a nursing assistant from another state who has no disqualifying criminal offence under Ark. Code Ann. § 17-3-102, has no pending complaint, allegation or investigation, and either has been 'in good standing for one (1) year with an occupational licensure of similar scope of practice issued by another state', or has worked at least three years in a state that does not license the occupation at all. A person granted it 'shall meet all other occupational licensure requirements for a resident of this state and all renewal requirements', DHS 'may require an applicant to pass an examination', and the rules also carry a template clause requiring a bond, financial statement or proof of insurance 'if required by state law' — no such requirement appears anywhere else in the nurse aide rules. Uniformed service members, veterans and spouses have their own expedited track under Arkansas Code § 17-4-101 et seq.: DHS will treat as qualifying either 'Ninety (90) hours of approved education, training, or experience in healthcare' or 'Passing the Arkansas nurse aide testing with three (3) given attempts within one hundred eighty (180) days post application'; the certificate expiry and any continuing education are extended by 180 days after a deployed member's return; and those who qualify 'shall be placed on the Certified Nursing Assistant registry and issued a state certificate.' Military candidates also 'receive priority service on test day' on producing service documents at check-in.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Arkansas Department of Human Services — Certified Nurse Aide (CNA) Training Program. The programme's own state page. Establishes that 'The Department does not require an initial fee for this occupational license; however, there is a fee to take the state examination'; the Arkansas Code Ann. § 17-5-104 fee-waiver categories and the carve-out for background checks, examinations and medical or drug tests; the contractor's identity and contact block ('For any inquiries on the Arkansas CNA Registry, please visit D&S Diversified Technologies', Arkansas Program Manager, PO Box 6609, Helena, MT 59604, testing 888-401-0462, registry 888-401-0465, fax 406-442-3357); the on-site testing city list (Springdale, Bentonville, Fort Smith, Ozark, Harrison, Blytheville, Little Rock, Pine Bluff, Batesville, Jonesboro, Monticello, Benton); the military provisions; and the links to the training-programme rules, the curriculum, the public registry search, and forms DMS-724 and DMS-741.\", \"url\": \"https://humanservices.arkansas.gov/divisions-shared-services/provider-services-quality-assurance/occupational-licensing/cna-nha-training-program/\"}, {\"label\": \"Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program (Arkansas DHS, Agency #016.06, 1992, revised July 1, 2024). The source of every rule quotation on this page: the 90-hour requirement and its 16-hour Part I / 74-hour Parts II-III structure, the 16 hours of supervised practical training, the permitted clinical sites, virtual training, the 24:1 classroom and 12:1 skills ratios, the ban on nursing assistants supervising clinical skills training, the facility-orientation exclusion, the one-hour-per-month in-service duty and the Barbara Broyles Alzheimer and Dementia Training, the four-month rule, the two-component examination and the three-attempt/twelve-month limits, the seven candidate qualification categories and the exclusions of personal care aides and unapproved programmes, the no-state-fee statement and the DHS payment of the examination fee for Medicaid-facility-connected candidates, the military and automatic out-of-state licensure provisions, the registry's contents and inquiry rules, 24-month renewal on eight documented paid hours 'in any setting', the over-24-month retest-plus-16-clinical-hours rule, and the neglect-finding petition.\", \"url\": \"https://humanservices.arkansas.gov/wp-content/uploads/Rules-for-the-AR-LTCF-NA-Training-Program-07012024.pdf\"}, {\"label\": \"Arkansas Long Term Care Facility Nursing Assistant Training Curriculum (Arkansas DHS). The published curriculum the rules make the examination blueprint — 'The examination shall be based upon the training curriculum requirements specified in the Long-Term Care Facility Nursing Assistant Training Curriculum Guide' — and the document that contains the Barbara Broyles Alzheimer and Dementia Training the rules name.\", \"url\": \"https://humanservices.arkansas.gov/wp-content/uploads/Curriculum_for_Nursing_Assistant_Training_Programs_2019-01_1.pdf\"}, {\"label\": \"Code of Arkansas Rules — Part 403, Rules for the Arkansas Long-Term Care Facility Nursing Assistant Training Program. The official codification, effective January 1, 2025 and updated weekly, carrying the codification note that records the rules' authority as Arkansas Code § 20-10-701 et seq. and their federal basis in the Nursing Home Reform Act.\", \"url\": \"https://codeofarrules.arkansas.gov/Rules/Rule?levelType=part&titleID=20&chapterID=38&subChapterID=50&partID=1157&subPartID=&sectionID=\"}, {\"label\": \"Code of Arkansas Rules — 20 CAR § 403-201, General rule. The codified four-month rule, with its authority given as Arkansas Code § 20-10-705.\", \"url\": \"https://codeofarrules.arkansas.gov/Rules/Rule?levelType=section&titleID=20&chapterID=38&subChapterID=50&partID=1157&subPartID=6850&sectionID=44415\"}, {\"label\": \"D&S Diversified Technologies / Headmaster — Arkansas Nurse Aide Testing, Certification and Registry Services. The contractor's Arkansas page, linked by DHS from its own CNA Training Program page. Establishes 'Headmaster is honored to partner with the Arkansas Department of Human Services to offer our Nurse Aide Testing and Registry Services'; the candidate handbook effective July 1, 2026; the reciprocity forms and the condition that form 9110AR requires that 'You MUST NOT be currently listed on the AR NA registry'; the separate 9110AR-REN out-of-state employment verification for renewal; the nursing student waiver form; the out-of-state training waiver; the ADA accommodation, refund and test review forms; and the RN test observer and test site materials.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/arkansas/AR_CNA_Home.htm\"}, {\"label\": \"Arkansas Nurse Aide Candidate Handbook, July 2026, version 10.0 (D&S Diversified Technologies / Headmaster, for the Arkansas Department of Human Services). Establishes the exam fee table (Knowledge Exam or Retake $30.00; Spanish version $30.00; Audio version $40.00; Audio Spanish $40.00; Skill Test or Retake $95.00), the $35 refund processing fee and 30-day refund window, the $25 test review deposit, the knowledge exam structure ('a maximum of 60 minutes to complete the 75-question knowledge exam' and 'You must have a score of 76% or better to pass'), the skills test as '3 or 4 tasks' in 'a maximum of 30 minutes' scored on 'all key steps (in bold font) and 80% of all steps', the 24-month registry renewal on 'at least eight (8) consecutive hours' of paid nurse aide work with employer email verification, the 60-day email and text renewal notice and the statement that 'No renewal certifications are sent via USPS mail', the out-of-state reciprocity and training waiver processes, the student nurse route, and the ADA accommodation process. Its own change log records that from July 1, 2026 'The skill tasks have been updated', the check-in time changed, the security section changed, and remotely proctored knowledge exam attire was added.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/arkansas/forms/ArkansasCandidateHandbook%207-2026.pdf\"}, {\"label\": \"Arkansas Nurse Aide Registry — public search (TestMaster Universe, operated for Arkansas DHS). The lookup itself; its own controls are the source of the search options listed under Verify a license on this page — Name, SSN, Registration Number and Misconduct, plus a downloadable misconduct list.\", \"url\": \"https://ar.tmutest.com/search\"}, {\"label\": \"Arkansas Nurse Aide Registry — applications (TestMaster Universe). Where candidates file the reciprocity form 9110AR, the out-of-state training waiver, the nursing student or RN candidate examination application, the demographic change/correction request, the ADA accommodation request, the refund request and the test review request.\", \"url\": \"https://ar.tmutest.com/apply\"}, {\"label\": \"Arkansas Department of Human Services — Office of Long Term Care. The parent office page within the Division of Provider Services and Quality Assurance, which links both the CNA & NHA Training Program page and the contractor's Arkansas nurse aide page.\", \"url\": \"https://humanservices.arkansas.gov/divisions-shared-services/provider-services-quality-assurance/office-of-long-term-care/\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR current text). The federal training-programme standard the Arkansas rules cite by number, including the 75-clock-hour floor Arkansas exceeds and the prohibition of charges to employed nurse aides.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/ar-cna/"
  },
  {
   "page_id": "az-cna",
   "state": "Arizona",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Arizona State Board of Nursing (AZBN) — the board maintains the Certified Nursing Assistant (CNA) Registry and separately licenses Licensed Nursing Assistants (LNAs). 1740 W Adams Street, Suite 2000, Phoenix, AZ 85007.",
   "board_url": "https://azbn.gov/licenses-and-certifications/apply-license",
   "application_url": "https://azbn.gov/licenses-and-certifications/apply-license",
   "renewal_cycle": "Every two years, on the last day of your birth month, and the condition is work rather than money or study. A.R.S. 32-1642(E): 'a certified nursing assistant shall file an application to renew the certified nursing assistant registration every two years on the last day of the certified nursing assistant's birth month. An applicant for renewal shall submit a verified statement that indicates whether the applicant has performed nursing or nursing-related services within the previous twenty-four consecutive months and whether the individual's registry entry includes documented findings of abuse, neglect or misappropriation of property. On receipt of the application, the board shall issue a renewal registration to each qualified renewal applicant.' The rule supplies the number the statute leaves out and makes it mandatory rather than merely disclosable — R4-19-810(A)(2): to renew CNA Registry status the applicant submits verified statements establishing '(a) Whether applicant has performed nursing assistant or nursing related services for at least eight hours within the past 24 months. An applicant must complete this work requirement to be eligible for renewal. (b) Whether the applicant's listing on any registry in any other state includes documented findings of abuse, neglect or misappropriation of property.' Note the second limb: Arizona asks about findings on any other state's registry, not just its own. Renewal is filed through the board's Nurse Portal and costs nothing on time. The LNA cycle looks similar and is not the same: an LNA also renews every two years on the last day of the birth month, but must show 'employment as a nursing assistant, performing nursing assistant tasks for an employer or the applicant's performance of nursing assistant activities as part of a nursing or allied health program for a minimum of 160 hours every two years since the last license or certificate was issued', and pay $50 (R4-19-809(A)(2)(f), A.R.S. 32-1643). Twenty times the hours, plus a fee.",
   "ce_hours": "None. Arizona requires no continuing education to keep a CNA registry listing. The renewal conditions are the verified work statement and the registry-findings disclosure, and nothing else: A.R.S. 32-1642(E) asks only for the verified statement, and R4-19-810(A)(2) lists exactly two things the applicant must establish — at least eight hours of nursing assistant or nursing-related services within the past 24 months, and whether any other state's registry carries findings against them. Neither an education requirement nor a refresher course appears in either. Sources checked: A.R.S. Title 32, Chapter 15 sections 32-1601, 32-1606, 32-1642, 32-1643, 32-1645, 32-1646, 32-1647, 32-1648 and 32-1649; A.A.C. Title 4, Chapter 19, Article 8 in full (R4-19-801 through R4-19-815, including the training program rules, the initial licensure and endorsement rules, the renewal rule and the registry rule); and the board's Agency Fees, Renew your License, Apply for a License, Primary Source Verification and NCLEX/NA/MA Exams pages. The closest thing to a recurring education obligation in the article belongs to someone else: a medication assistant seeking a subsequent certificate must document 'eight hours of continuing education specific to medications, medication administration, and performance of selected patient treatments' from a board-approved medication education programme, a professional association's approved continuing education, or a nursing home staff development programme — a reinstatement condition on the CMA credential, not a renewal condition on the CNA.",
   "exam": "Both parts, and Arizona's deadline is two years rather than a CAP on attempts. A.R.S. 32-1647(A): 'An applicant for licensure as a licensed nursing assistant or an applicant for registration as a certified nursing assistant who wishes to be placed on the registry of nursing assistants shall pass both the written and manual skills competency examinations on subjects contained in the licensed nursing assistant or certified nursing assistant training program approved by the board.' The failure rule is a clock, not a count — A.R.S. 32-1647(C): 'If a certified nursing assistant applicant fails to pass either the written or the manual skills competency examination within two years after completing an educational program, the applicant shall complete to the board's satisfaction an approved nursing assistant training program before the applicant may take that examination again.' Arizona sets no maximum number of attempts for the CNA; the rules describe retakes on the parallel LNA track as available 'under conditions prescribed in written policy by the exam vendor, until a passing score is achieved or their time expires' (R4-19-806(D)(3)), with the same consequence when time runs out: 'An applicant who does not take or pass an examination within the time period specified... shall enroll in and successfully complete a Board approved training program in the certification category before being permitted to retake an examination' (R4-19-806(E)). The registry rule states the two-year window from the other side: placement requires having 'passed the nursing assistant written and manual skills competency evaluation within the past two years' (R4-19-810(A)(1)(a)). Cost: AZBN's fee table lists 'CNA Exam $0' — the board charges nothing for the CNA examination application. Program accountability: a training program 'shall attain, at a minimum, an annual first-time passing rate on the manual skill and written certifying examinations that is equal to the Arizona average pass rate for all candidates on each examination minus 20 percentage points,' with a notice of deficiency issued to any program of five or more test-takers that misses it in a calendar year (R4-19-801(E)). The board publishes annual NA program pass-rate reports. Arizona publishes no passing score, question count or time limit for the state examination on the pages read, and this page states none.",
   "fees": "The CNA is free to get and free to keep — and the two exceptions are where the money is. From AZBN's own Agency Fees table: 'CNA Exam $0'; 'CNA: Every 2 Years $0' under Renewals. The statute backs the pattern rather than merely permitting it — the fee section, A.R.S. 32-1643, sets amounts for 'Issuing a license to an applicant to become a licensed nursing assistant or licensed health aide, $50', 'Issuing a license to a licensed nursing assistant or licensed health aide applicant for renewal, $50', and 'Application for renewal of a licensed nursing assistant or licensed health aide license after its expiration, $25 for each year it is expired, not to exceed a total of $100' — and lists no fee for the certified nursing assistant anywhere in its 28 items. The renewal statute mirrors the same asymmetry in a single word: for an LNA, 'On receipt of the application and fee, the board shall issue a renewal license'; for a CNA, 'On receipt of the application, the board shall issue a renewal registration' (A.R.S. 32-1642(D) and (E)). Two CNA charges do exist, both on the board's fee table: 'CNA/LNA Endorsement $50' — coming in from another state's registry is not free — and, under Late Fee, 'CNA/LNA Renewal $10/yr since last renewed'. The LNA column, for comparison: LNA Exam $50; CNA/LNA Endorsement $50; Background Check $50; 'LNA: Every 2 Years $50' renewal; LNA Reinstatement $75; late renewal $10 per year since last renewed. Other Board charges that can reach a nursing assistant: 'Verification of Certification/Licensure $50'; 'Failure to Report Change of Address $25' (the statute sets the same $25 at 32-1643(A)(28)); 'Copying of Records .50¢/page if > 10 pages'; 'Insufficient Fund Check $50'. A payment surcharge applies to every card transaction, in force since September 11, 2025: 'The Office of the State Treasurer has awarded a new merchant services contract to manage the processing of card payments for all Arizona state agencies. Beginning September 11, 2025, a $2.00 or 2.2% (whichever is greater) processing fee will be charged on all credit and debit card transactions. eCheck (ACH) payments will remain free of charge.' AZBN heads its table 'ALL FEES ARE NON-REFUNDABLE.' Not Board fees: training program tuition, and whatever the contracted testing vendor charges a candidate. One rule limits tuition in a specific setting: 'A Medicare or Medicaid certified long-term care facility-based nursing assistant program shall not require a student to pay a fee for any portion of the program including the initial attempt on the state competency exam.'",
   "legal_basis": "[{\"citation\": \"A.R.S. Title 32, Chapter 15 (Nursing) — §§ 32-1601, 32-1606, 32-1642, 32-1643, 32-1645 to 32-1650\", \"what_it_governs\": \"The definitions that make a CNA a registry registration and an LNA a licensee (32-1601(6), (15), (25)); board powers including the registry duty (32-1606); renewal cycles, including the two-year birth-month cycle and the 'application and fee' versus 'application' distinction between LNA and CNA renewal (32-1642(D)-(E)); the complete fee schedule, which prices LNA and LHA licensure and names no CNA fee (32-1643); the qualifications for LNA, CNA and LHA and the minimum age of sixteen (32-1645); board powers over LNAs and CNAs including the felony bar for LNAs and the substantiated-complaint notation for CNAs (32-1646); the requirement to pass both the written and manual skills competency examinations and the two-year retraining trigger (32-1647); acceptance of out-of-state licenses and registry listings (32-1648); exclusive use of the titles LNA and CNA (32-1649); and the certified medication assistant scheme (32-1650).\", \"url\": \"https://www.azleg.gov/ars/32/01645.htm\"}, {\"citation\": \"A.A.C. Title 4, Chapter 19, Article 8 (Certified Nursing Assistants and Certified Medication Assistants) — R4-19-801 through R4-19-815, Arizona Administrative Code Supp. 24-4, December 31, 2024\", \"what_it_governs\": \"Common standards for nursing assistant and medication assistant training programs, including the test-vendor reporting duties, the tuition-transparency and refund rules, the final-examination policy, records retention, the certifying-exam passing standard and distance-learning approval (R4-19-801); nursing assistant program requirements including the 120-hour curriculum and its 40/20/40 plus 20 split, the 20 hours of direct resident care in a licensed long-term care facility, the 16-hour pre-contact rule, advanced placement, coordinator and instructor qualifications and the 10-to-1 clinical ratio (R4-19-802); program approval and re-approval (R4-19-804); initial LNA licensure and CMA certification, including the six education routes and the two-year certifying-exam window (R4-19-806); licensure and certification by endorsement, including the two-year active-listing test and the 160-hour activity test (R4-19-807); LNA and CMA renewal, including the 160-hour practice requirement and the two-year birth-month expiry (R4-19-809); and the CNA Registry and LNA Registry, their contents, the placement routes and the eight-hour renewal work requirement (R4-19-810).\", \"url\": \"https://apps.azsos.gov/public_services/Title_04/4-19.pdf\"}, {\"citation\": \"Omnibus Budget Reconciliation Act of 1987 (P.L. 100-203), as amended by the Medicare Catastrophic Coverage Act of 1988 (P.L. 100-360)\", \"what_it_governs\": \"The federal nurse aide registry requirement Arizona's CNA credential implements. A.R.S. 32-1601(25) defines the 'registry of nursing assistants' as the registry 'maintained by the board pursuant to' that act, and 32-1645(B) requires a CNA applicant to file 'a verified form prescribed by the board and authorized by' it. The board's own explanation of why the CNA carries no fee rests on the same federal frame: the CNA requirements are 'the minimum required by federal law to be listed on a Nurse Aide Registry and, consistent with federal law, do not include fees for initial placement or renewal on the Registry.' Cited because Arizona cites it; the federal text was not separately read for this page.\", \"url\": \"https://www.azleg.gov/ars/32/01601.htm\"}]",
   "exam_vendor": "Arizona contracts the examination out, and the Board's publicly readable pages do not name the company. What the state does say is that a contracted vendor exists and what it does. The board's Primary Source Verification page: 'For examination applicants, primary source verification is sent to AZBN from the contracted testing vendor who receives documentation from the Board approved nursing assistant training program validating that the examination applicant has successfully completed the Board approved nursing assistant training program, and verification that the applicant has passed the manual and skills nursing assistant examination.' The rules call the same party 'the Board-approved test vendor' and give it three concrete jobs: within the first 14 days of a program and before 50 percent of instruction, the program 'shall transmit to the Board-approved test vendor, accurate and complete information regarding each enrolled student for the purposes of tracking program enrollment, attrition and completion. Upon receipt of accurate completion information, the vendor shall issue a certificate of completion to the program for each successful graduate' (R4-19-801(A)(7)); the program must remit each student's proof of legal presence 'to the Board's designated testing vendor in order to facilitate timely placement of program graduates on a nursing assistant registry' (R4-19-801(D)(2)(e)); and retakes run 'under conditions prescribed in written policy by the exam vendor' (R4-19-806(D)(3)). The Board is also clear that the examination itself is the state's: 'the state manual skills/written exams', with results feeding the Board's registry directly. The vendor's name could not be sourced from any Arizona page readable when this page was compiled — the pages that would carry it could not be opened — and it is deliberately left unstated here rather than guessed.",
   "training_hours": "120 hours total — well above the federal floor — with a three-way split plus a flexible block, all set by rule. A.A.C. R4-19-802(D)(1): 'A nursing assistant training program shall ensure each graduate receives a minimum of 120 hours of total instruction consisting of: a. Instructor-led teaching in a classroom setting for a minimum of 40 hours; b. Instructor-supervised skills practice and testing in a laboratory setting for a minimum of 20 hours; and c. Instructor-supervised clinical experiences for a minimum of 40 hours, consistent with the goals of the program.' That is 100 hours accounted for; the rule then requires the program to place the remaining 20: 'To meet the 120 hour minimum program hour requirement, a NA program shall designate an additional 20 hours to classroom, skill or clinical instruction based upon the educational needs of the program's students and program resources.' A setting requirement sits inside the clinical hours: 'The program shall provide a minimum of 20 hours of direct resident care in a long-term care facility licensed by the Department of Health Services,' and 'Direct resident care does not include orientation and clinical pre and post conferences.' If another health care facility supplies additional required hours, the program must ensure it 'provides opportunities for students to apply nursing assistant skills similar to those provided to long-term care residents'; and if no licensed long-term care facility is available within 50 miles of the program's classroom, the program may use 'a facility or unit that cares for residents or patients similar to those residing in a long-term care facility.' A sequence rule governs when a student may touch a patient: 'A nursing assistant training program shall provide a student with a minimum of 16 hours instruction in the subjects identified in subsections (F)(1) through (F)(6) before allowing a student to care for patients or residents' (R4-19-802(G)). Advanced placement — a shorter path for people with a health care background, but only with board approval of the program's policy: it is 'limited to students with at least one year full-time employment in the direct provision of health care within the past five years or students who have successfully completed course work that included direct patient care experiences in allied health, medicine or nursing in the past five years'; the student must 'meet the same outcomes as regular students on all examinations and skill performance demonstrations' and must 'successfully accomplish all clinical objectives during a minimum of 16 hours of clinical practice under the direct supervision and observation of a qualified instructor and in a long-term care facility'; and on completion 'the program shall credit the graduate with the same number of didactic, laboratory and clinical hours as the regular graduate.' Supervision ratios travel with the hours: clinical groups may 'not exceed 10 students per instructor', and 'A qualified RN instructor shall be present at all times and during all scheduled classroom, skills laboratory and clinical sessions. In no instance shall a nursing assistant or other unqualified person provide any instruction, reinforcement, evaluation or independent activities in the classroom or skills laboratory.' One cost rule worth knowing before enrolling: 'A Medicare or Medicaid certified long-term care facility-based nursing assistant program shall not require a student to pay a fee for any portion of the program including the initial attempt on the state competency exam' (R4-19-802(A)(4)).",
   "lapse_rule": "Two different clocks can end a CNA listing, and they bite at different moments. (1) the work requirement at renewal. R4-19-810(A)(2)(a) is unambiguous that the eight hours are a gate, not a disclosure: 'Whether applicant has performed nursing assistant or nursing related services for at least eight hours within the past 24 months. An applicant must complete this work requirement to be eligible for renewal.' A CNA who cannot make that statement cannot renew. (2) the two-year examination window, which matters to anyone re-entering. A.R.S. 32-1647(C): 'If a certified nursing assistant applicant fails to pass either the written or the manual skills competency examination within two years after completing an educational program, the applicant shall complete to the board's satisfaction an approved nursing assistant training program before the applicant may take that examination again.' And placement on the registry requires having passed both parts 'within the past two years' (R4-19-810(A)(1)(a)) — so a stale pass does not carry you back on. Late renewal is priced, which implies it is possible: AZBN's fee table lists a late fee for 'CNA/LNA Renewal $10/yr since last renewed'. No Arizona source we checked states a maximum lapse period for a CNA, a reinstatement procedure specific to the CNA, or a rule that a CNA lapsed beyond some number of years must retrain — the retraining trigger Arizona does publish is the examination-window rule above, not an elapsed-listing rule. That absence was searched for, not assumed: A.R.S. 32-1642, 32-1645, 32-1647 and 32-1648 and A.A.C. R4-19-806, R4-19-807, R4-19-809, R4-19-810 and R4-19-815 were all read for it. By contrast the LNA side does have an explicit lapse regime — an LNA license 'expires every two years on the last day of the applicant's birth month. If an applicant fails to timely renew the license or certificate, the applicant shall: 1. Not work or practice as an LNA or CMA until the Board issues a renewal license or certificate; and 2. Pay any late fee imposed by the Board' (R4-19-809(B)) — plus an LNA Reinstatement fee of $75 and a statutory late-renewal charge of '$25 for each year it is expired, not to exceed a total of $100.' Discipline is a separate kind of ending: the board may 'Investigate allegations of abuse, neglect or misappropriation of property and refer criminal violations to the appropriate law enforcement agency' and may 'indicate on the registration the existence of any substantiated complaints against the certified nursing assistant' (A.R.S. 32-1646(C)). Rule R4-19-810(C) requires the Executive Director to record, for a finding by the board or by the U.S. Department of Health and Human Services, 'The finding, including the date of the decision, and a reference to each statute, rule, or regulation violated' and 'The sanction, if any, including the date of action and the duration of action, if time-limited.' The board also states that any substantiated allegation of abuse, neglect or misappropriation or theft 'will be reported to the Office of Inspector General (OIG) and will be listed on the registry.'",
   "reciprocity": "Endorsement onto the registry, and the choice of tier is the applicant's. Statute: 'The board may register a person as a certified nursing assistant who has been listed on the nursing assistant registry maintained in another state if the nursing assistant provides to the board current proof of registration or an equivalent document issued by another state and the board receives an application pursuant to section 32-1645 and determines that the applicant meets the qualifications of this article' (A.R.S. 32-1648(C)); the parallel subsection (A) does the same for LNA licensure. The board explains the fork: 'CNAs endorsing from another state will need to submit an application and choose whether to become a CNA or obtain an LNA license,' and 'Nursing assistants from other states may apply for a CNA endorsement for a $50.00 fee, or for an LNA endorsement and submit a background check for an additional $50.00.' Currency test: 'Your out-of-state CNA certificate must be active or have been active in the last 2 years from the date of your application,' which the rule states as being 'or has been, within the last 2 years, listed as active on a nursing assistant register or a substantially equivalent register by another state or territory of the United States with no substantiated complaints or discipline' (R4-19-807(D)(1)). Education test: the out-of-state program must have been at least 120 hours, or at least 75 hours with enough documented nursing assistant work in the past two years to reach 120 in total — the board summarises the second as '75-hour nursing assistant program approved by another state AND proof of working at least 45 hours as a nursing assistant.' Activity test, on top of the currency test: a nursing assistant endorsement applicant must also show that, 'Regardless of job title or description, [they] performed nursing assistant activities for a minimum of 160 hours for an employer or as part of a nursing or allied health program in the past two years; or Has completed a nursing assistant training program and passed the required examination within the past two years' (R4-19-807(D)(2)). Documents: a Certificate of Completion from a board-approved nursing program or the out-of-state proof above, plus citizenship, nationality or alien status documentation; fingerprints only if applying for the LNA. How Arizona verifies you: 'For endorsement applicants, primary source verification is obtained from the website of another state or territory of the United States to validate that the CNA is listed as active on a nursing assistant register or a substantially equivalent register' — so Arizona checks your home state's own public register rather than asking you to chase a form. An applicant with a history gets an unusual safety net, and the board publishes it: 'If an applicant applies for an LNA and discloses or the Board discovers a criminal background or other potential unprofessional conduct, the Board will review the application and may conduct an investigation. During the investigation period, if the applicant successfully completes the CNA education and exam requirements, the Board will list the applicant on the CNA Registry.' The catch is stated in the same breath: 'An LNA application, once submitted, may not be withdrawn to avoid an investigation or possible Board disciplinary action.' Going the other way: Arizona charges $50 for a 'Verification of Certification/Licensure', and the statute prices verification to another state at $50 as well. ⚠ AZBN's FAQ — the same answer that states the $50 endorsement fee — phrases the education test more loosely, as completion of 'an out-of-state nursing assistant program for a minimum of 75 hours' with no work top-up mentioned. The rule's 120-hour arithmetic is the operative test; both phrasings are the board's own words and both are recorded.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Arizona State Board of Nursing — Agency Fees. The live fee table. Establishes 'CNA Exam $0', 'LHA Exam $50', 'LNA Exam $50', 'CNA/LNA Endorsement $50', 'Background Check $50'; under Renewals, 'CNA: Every 2 Years $0', 'LNA: Every 2 Years $50', 'CMA: Every 2 Years $0', 'LHA: Every 4 Years $50'; under Reinstatement, 'LNA Reinstatement $75'; under Late Fee, 'CNA/LNA Renewal $10/yr since last renewed'; under Other, 'Failure to Report Change of Address $25', 'Verification of Certification/Licensure $50', 'Copying of Records .50¢/page if > 10 pages' and 'Insufficient Fund Check $50'; the heading 'ALL FEES ARE NON-REFUNDABLE'; and the card-payment surcharge notice effective September 11, 2025 ('a $2.00 or 2.2% (whichever is greater) processing fee will be charged on all credit and debit card transactions. eCheck (ACH) payments will remain free of charge').\", \"url\": \"https://azbn.gov/licenses-and-certifications/agency-fees\"}, {\"label\": \"Arizona State Board of Nursing — Primary Source Verification. Establishes that AZBN is a primary source 'as required by the Joint Commission'; that nurse information is 'uploaded to NURSYS (APRN/RN/LPN) or the AZBN Verification Portal (CNA/LNA/CMA/LHA)'; that 'The AZBN Online Verification System is a primary source verification of licensure/certification of all nursing assistant, medication assistant, health aide, and school nurse credentials'; and the CNA-specific paragraph on how the board verifies education and examination — from 'the contracted testing vendor' for exam applicants and 'from the website of another state or territory of the United States' for endorsement applicants.\", \"url\": \"https://azbn.gov/licenses-and-certifications/primary-source-verification\"}, {\"label\": \"Arizona State Board of Nursing — NCLEX / NA / MA Exams. Establishes 'The nursing assistant exam has two parts, a written section and a skills evaluation. Both parts must be passed', and that the board publishes annual NA program pass-rate reports and a 2024 Nursing Assistant Competency Exam Changes document.\", \"url\": \"https://azbn.gov/education/nclex-na-ma-exams\"}, {\"label\": \"Arizona State Board of Nursing — Apply for a License, CNA / LNA section. Read from an archived copy of the page dated 14 March 2026, because the live page could not be opened directly; every substantive figure taken from it was cross-checked against the live statute, the live administrative code or the live Agency Fees table, and the passages relied on are the board's narrative explanation. Establishes the CNA-by-endorsement and CNA-by-exam requirement lists; 'Your out-of-state CNA certificate must be active or have been active in the last 2 years from the date of your application'; 'Proof of completion at least 120-hour nursing assistant program approved by another state OR Proof of completing at least 75-hour nursing assistant program approved by another state AND proof of working at least 45 hours as a nursing assistant'; 'CNA applicants are NOT required to submit fingerprints to the Arizona State Board of Nursing to be certified'; the LNA fingerprint requirements and timelines; the Rationale for CNA & LNA Change in full, including 'which is prohibited by federal law' and the 2014 legislative history; the one-line definitions of CNA and LNA; 'The titles CNA and LNA are mutually exclusive'; the FAQ answers that the training program is the same for both, that LNAs appear on the nurse aide registry 'titled and listed as LNA', that endorsing nursing assistants 'may apply for a CNA endorsement for a $50.00 fee, or for an LNA endorsement and submit a background check for an additional $50.00', and the treatment of an LNA applicant with a criminal or conduct history.\", \"url\": \"https://azbn.gov/licenses-and-certifications/apply-license\"}, {\"label\": \"Arizona State Board of Nursing — Renew your License. Establishes the credential tabs the board renews (APRN/RN/LPN, CMA, CNA/LNA, LHA, School Nurse) and the navigation to Agency Fees, Credential Verification (CNA/LNA/CMA/LHA) and License Verification (RN/LPN/APRN).\", \"url\": \"https://azbn.gov/licenses-and-certifications/renew-your-license\"}, {\"label\": \"Arizona State Board of Nursing — License/Certificate Verification Portal (the board's own lookup for CNA, LNA, CMA, LHA and school nurse credentials). Its live search form establishes the search options listed under Verify a license on this page: last name and first name with a maiden-and-other-names option, credential type from the list CMA / CNA / LHA / LHA2 / LHA3 / LNA / SN / UCNA, credential number with credential type, and NCSBN ID.\", \"url\": \"https://azbn.boardsofnursing.org/licenselookup\"}, {\"label\": \"Arizona Revised Statutes 32-1645 (Licensed nursing assistants; certified nursing assistants; licensed health aides; qualifications), from the Arizona Legislature. Establishes the CNA application clause with no fee requirement, the three proofs a CNA applicant must submit, the parallel LNA and LHA clauses that do require the 32-1643 fee, and 'A person who wishes to practice as a certified nursing assistant or a licensed nursing assistant shall be at least sixteen years of age.'\", \"url\": \"https://www.azleg.gov/ars/32/01645.htm\"}, {\"label\": \"Arizona Revised Statutes 32-1647 (Examination of licensed nursing assistants and certified nursing assistants). Establishes that an applicant 'shall pass both the written and manual skills competency examinations on subjects contained in the licensed nursing assistant or certified nursing assistant training program approved by the board', and the two-year retraining trigger for a CNA applicant who has not passed both parts.\", \"url\": \"https://www.azleg.gov/ars/32/01647.htm\"}, {\"label\": \"Arizona Revised Statutes 32-1642 (Renewal of license or registration; failure to renew). Establishes the two-year birth-month renewal for both the LNA license and the CNA registration, the verified statements each must submit, and the textual asymmetry between 'On receipt of the application and fee, the board shall issue a renewal license' (LNA) and 'On receipt of the application, the board shall issue a renewal registration' (CNA).\", \"url\": \"https://www.azleg.gov/ars/32/01642.htm\"}, {\"label\": \"Arizona Revised Statutes 32-1643 (Fees; penalties). Establishes the board's complete fee schedule — including $50 to issue an LNA or LHA license, $50 to renew one, '$25 for each year it is expired, not to exceed a total of $100' for late LNA or LHA renewal, $50 for a temporary LNA license, $50 for verification to another state, $50 for processing fingerprint cards and $25 for failing to notify the board of a change of address — and, by its silence across all 28 items, that no fee is set for the certified nursing assistant.\", \"url\": \"https://www.azleg.gov/ars/32/01643.htm\"}, {\"label\": \"Arizona Revised Statutes 32-1601 (Definitions), 32-1646 (board powers over LNAs and CNAs), 32-1648 (acceptance of out-of-state licenses and registry listings) and 32-1649 (use of title). Establish that a CNA is 'a person who is registered on the registry of nursing assistants', that the term excludes licensed health care professionals, volunteers, and licensed nursing assistants, the definition of the OBRA-87 registry of nursing assistants, the board's power to note substantiated complaints on a CNA registration, the discretionary endorsement power for out-of-state registrants, and the exclusive titles LNA and CNA.\", \"url\": \"https://www.azleg.gov/ars/32/01601.htm\"}, {\"label\": \"Arizona Administrative Code, Title 4, Chapter 19 (Board of Nursing), Article 8 — Supp. 24-4, December 31, 2024, from the Arizona Secretary of State. Establishes R4-19-801 (common program standards, the Board-approved test vendor's reporting and certificate-of-completion role, the legal-presence remittance, the 75% final-exam standard, the pass-rate standard and the site-visit and distance-learning rules); R4-19-802 (the 120-hour curriculum with its 40 classroom / 20 lab / 40 clinical minimums plus 20 designated hours, the 20 hours of direct resident care in a licensed long-term care facility, the 50-mile alternative, the 16-hour pre-contact rule, advanced placement including its 16 clinical hours, and the 10-students-per-instructor clinical ratio); R4-19-806 (initial LNA and CMA application contents, the six nursing assistant education routes including the 120-hour and 75-plus-work options and the 100-hour military route, the two-year certifying-exam window and the vendor-policy retake rule); R4-19-807 (endorsement, the two-year active-listing test and the 160-hour activity test); R4-19-809 (LNA and CMA renewal, the 160-hour practice requirement, the two-year birth-month expiry and the bar on practising while lapsed); and R4-19-810 (the CNA and LNA Registries, the two placement routes, the eight-hour work requirement for CNA registry renewal, the registry contents and the recording of board and HHS findings).\", \"url\": \"https://apps.azsos.gov/public_services/Title_04/4-19.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/az-cna/"
  },
  {
   "page_id": "ca-cna",
   "state": "California",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "California Department of Public Health (CDPH) — Center for Health Care Quality, Licensing and Certification Program; Healthcare Workforce Branch (HWB), Healthcare Professional Certification and Training Section (HPCTS)",
   "board_url": "https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx",
   "application_url": "https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx",
   "renewal_cycle": "Every two years, and California renews on three conditions, not one. CDPH: 'CNA certificates must be renewed every two (2) years. You may renew your certificate any time within two (2) years after the expiration date of your certificate, if by the time your certificate expires you will have completed the following: You have previously received and maintained criminal record clearance for CNA, HHA, Intermediate Care Facility-Developmentally Disabled (ICF-DD), DD Habilitative, or DD Nursing and a criminal clearance is granted. You have provided nursing or nursing-related services in a facility to residents for compensation (under the supervision of a licensed health professional) within your most recent certification period. You have successfully obtained and submitted documentation of forty-eight (48) hours of In-Service Training/CEUs within your most recent certification period.' The work requirement is small but real: 'One (1) of the two (2) renewal requirements is that you work at least one (1) day for pay providing nursing or nursing-related services to residents in a facility under the supervision of a licensed health professional.' (That CDPH sentence counts two renewal requirements; CDPH's renewal list quoted above names three, including criminal record clearance. This page follows the list.) Where that day is worked matters — CDPH lists acceptable settings as 'Skilled Nursing Facilities, Acute Hospitals, Alzheimer's Units, Clinics, Disability Habilitative (ICF/DDH) - ICF/Developmentally Disabled Nursing (ICF/DDN), Home Health Agencies, Hospice, Intermediate Care Facility (ICF) – ICF/Developmentally, Prison System Facilities, Psychiatric Facilities, Sheriff's Department Medical Unit' and unacceptable settings as 'In-home care, Staffing agencies, Home Health Agency'. ⚠ Those two lists contradict each other: 'Home Health Agencies' appears on the acceptable list and 'Home Health Agency' on the unacceptable list, on the same CDPH page. Both are recorded here rather than reconciled. In-Home Supportive Services is specifically excluded: 'No, IHSS is considered private duty.' Timing: renewal may be filed 'up to six months prior to the expiration date on the certificate', and CDPH sends a renewal notice by mail — but 'The Renewal Application is available for download from our website' if it does not arrive. Renewal may be filed on paper or online; CDPH announced that 'OASYS now offers a fully online process for CNA renewal applications.' The certification period is measured in birthdays: 'The initial CNA/HHA certificate is issued for two birthdays, not two years, and will expire on your birthday. Each year of the certification period will be from one birthday to the following birthday, any additional time from the issue date until the first birthday will be counted towards the first year of the certification period.' CDPH publishes a Certification Period Calculator spreadsheet because of it. CDPH's renewal application (CDPH 283C) is the aide's own signed application — no CDPH source states who else, if anyone, may file it — and the in-service log (CDPH 283A) must be signed by the instructor responsible for the training and 'retained by the CNA/HHA for a period of four (4) years.'",
   "ce_hours": "48 hours of in-service training or continuing education per two-year certification period — the highest requirement of any state on this site, and double the HHA requirement. CDPH's rule, stated on both the renewal application and the in-service form: 'CNAs: Must obtain forty-eight (48) hours of In-Service Training/CEUs within the certification period. A minimum of twelve (12) of the forty-eight (48) hours shall be completed in each year of the two (2) year certification period. A maximum of twenty-four (24) of the forty-eight (48) hours may be obtained only through a CDPH-approved online computer training program listed on our website.' So the hours cannot be crammed into the final months, and at most half may be online. Who may provide them: 'Only CDPH-approved In-Service Training Programs and CDPH-approved CEU providers with a Nurse Assistant Certification Number (NAC#) are accepted' — in-service training must come from 'a health facility where the CNA/HHA has been employed within the most recent certification period', while CEUs must come from a CDPH-approved provider whose NAC# appears on the certificate. Credit conversions CDPH publishes: nursing coursework counts — 'One (1) semester unit = fifteen (15) hours; One (1) quarter unit = ten (10) hours' for LVN, RN or Licensed Psychiatric Technician programs, with a transcript required; and 'If the CDPH-approved HHA Training Program (40-hour program) was completed during the certification period, twenty-six (26) hours of the forty (40-hour) training program may count towards CEUs.' A hard floor on session length: 'Training less than 50 minutes increments cannot be counted towards the CEU/In-Service training renewal requirement.' Abuse-prevention content is mandated by statute inside the recurring hours: 'A minimum of four hours of instruction on preventing, recognizing, and reporting instances of resident abuse, including instruction on preventing, recognizing, and reporting residents' rights violations, shall be included within the total minimum hours of continuing education or in-service training required and in effect for certified nurse assistants' (H&S Code 1337.1(e)(2)). Paid time: CDPH's form states that 'CNAs are to receive the normal hourly wage for attending the In-Service on their regularly scheduled shift or during another shift.' Documentation goes in on form CDPH 283A with the instructor's printed name, signature and title, and online CEU certificates must be attached.",
   "exam": "California calls it the competency evaluation, and it has two portions — a written (knowledge) test and a skills test. Certification requires completing 'a training program approved by the department in California, which includes an examination to test the applicant's knowledge and skills related to basic patient care services', and the statute charges CDPH with developing 'program content for orientation, training, inservice and the examination for testing knowledge and skills related to basic patient care services' (H&S Code 1337.3(d)). CDPH's records refer to 'the date you completed both portions of the competency evaluation'. An audio/oral version exists: D&SDT-Headmaster publishes an 'Audio Version of the Knowledge Exam' and separate 'Remotely Proctored Knowledge Exam Instructions' alongside in-person instructions. Language — a statutory deadline that has passed: H&S Code 1337.3(a)(2), as amended by Stats. 2025, ch. 243 (SB 862), effective January 1, 2026, provides that 'No later than December 31, 2025, the department shall solicit applications from vendors to provide the written and oral competency examination of a nurse assistant certification examination in Spanish.' That date has passed. CDPH's CNA Testing Vendors page, as read on September 24, 2026, does not mention a Spanish-language examination, and this page does not say whether CDPH has solicited or engaged a vendor. Program-level pass-rate pressure: CDPH must 'examine each training center's trainees' competency test passage rate, and require each program to maintain an average 60 percent test score passage rate to maintain its participation in the program', calculated over two years (1337.3(b)). Score delivery: results go from the vendor to CDPH, and CDPH warns candidates to 'allow at least sixty (60) days for CDPH to receive your examination results from the testing vendor.' CDPH's own pages do not publish the number of written questions, the time limit, the number of skills tested, the passing score or the number of attempts allowed before retraining; those figures live in each vendor's own candidate handbook, so this page does not state a single California-wide answer. D&SDT-Headmaster's California Nurse Aide Candidate Handbook (March 2026, version 9.0) gives its own: 'The Knowledge Test consists of 75 multiple-choice questions', with 'a maximum of sixty (60) minutes' to complete it, and 'You must have a score of 75% or better to pass the knowledge portion of the exam'; the skill test is three or four randomly selected tasks in thirty minutes; and 'You have three (3) attempts to pass the exam's knowledge and skill test portions within two (2) years from your date of nursing assistant training program completion', after which a new CDPH-approved training program is required. The figures of Credentia and the Regional Testing Center were not read and are not stated here.",
   "fees": "CDPH charges nothing to certify or renew. Its own FAQ answers it in one line: 'What are the processing fees? There are no processing fees for your application.' No fee appears on the CDPH 283B initial application, the CDPH 283C renewal application, the CDPH 283E equivalency/reciprocity application or the CNA program page. What a candidate does pay: (1) fingerprinting — Live Scan is done through a private Live Scan agency at that agency's rolling fee plus the state/federal fees, none of which CDPH publishes; an applicant who cannot obtain electronic prints instead sends two FD-258 fingerprint cards 'accompanied by a $32.00 check or money order made payable to \"The Department of Justice\"'. (2) testing fees, set by the vendor, not by CDPH — D&SDT-Headmaster, one of the three CDPH-approved vendors, published on its California nurse aide page: 'EFFECTIVE 3-1-2026: Testing fees price increase: Knowledge Exam $40, Audio Version of the Knowledge Exam $45, Skills Test $100.' Credentia and the Regional Testing Center set their own; we have not read those figures, so they are not stated here. (3) training cost — set by each approved program and not published by CDPH. Note that the vendor also allows training programs and sponsoring facilities to pay testing fees on a candidate's behalf ('How to Pay Testing Fees (for Training Programs and Sponsoring Facilities)'), so many candidates never see the exam fee directly.",
   "legal_basis": "[{\"citation\": \"Cal. Health & Safety Code 1337 (definitions and scope), Article 9, Chapter 2, Division 2 — 'Training Programs in Skilled Nursing and Intermediate Care Facilities' [1337-1338.6], Article 9 added by Stats. 1978, Ch. 351; section 1337 amended by Stats. 2009, 4th Ex. Sess., Ch. 5, Sec. 8, effective July 28, 2009\", \"what_it_governs\": \"The definitions of 'nurse assistant', 'approved training program' and 'certified nurse assistant'; the settings the article does not reach (ICF/DD facilities with Department of Developmental Services-approved training, general acute care hospitals, acute psychiatric hospitals, special hospitals); and the rule that criminal record clearance is required on certification and biannually thereafter regardless of employment setting.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.&lawCode=HSC\"}, {\"citation\": \"Cal. Health & Safety Code 1337.1 (approved training program contents), amended by Stats. 2019, Ch. 497, Sec. 151 (AB 991), effective January 1, 2020\", \"what_it_governs\": \"The orientation program, the 60 classroom hours and 100 supervised clinical hours, the dementia and developmental-disability content minimums, the six hours of abuse-prevention and one hour of residents'-rights instruction inside the 60, the four hours of abuse-prevention instruction inside the recurring in-service hours, transferable credit between approved programs, and the exemption for a facility that employs only certified nurse assistants.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.1.&lawCode=HSC\"}, {\"citation\": \"Cal. Health & Safety Code 1337.3 (approved training program list, inspection, and program contents), amended by Stats. 2025, Ch. 243, Sec. 4 (SB 862), effective January 1, 2026\", \"what_it_governs\": \"CDPH's duty to maintain and (from July 1, 2029) publish the approved-training-program list with pass rates by test language; the 60 percent program pass-rate floor measured over two years; the 16-hour orientation and the 60+100 hour program restated 'notwithstanding Section 1337.1'; the December 31, 2025 duty to solicit vendors for a Spanish written and oral competency examination; the church-or-denomination exemption; the community-college credit process; and the standards for online and distance-learning programs including the required contract with a licensed SNF or ICF for the clinical portion.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.3.&lawCode=HSC\"}, {\"citation\": \"Cal. Health & Safety Code 1337-1338.5 generally, including 1338.5 (criminal record review), as cited by CDPH\", \"what_it_governs\": \"CDPH names this range as the authority for the whole program — 'ensuring applicants adhere to the California Health and Safety Code, Section 1337-1338.5' — and quotes 1338.5(2)(A) for the enrolment-time application rule: 'Upon enrollment in a training program for nurse assistant certification, and prior to direct contact with residents, a candidate for training shall submit a training and examination application and the fingerprint cards to the State department to receive a criminal record review through the Department of Justice.' Section 1338.5's own full text was not separately read for this page; the quoted sentence comes from CDPH's FAQ.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.&lawCode=HSC\"}, {\"citation\": \"22 Cal. Code Regs. tit. 22, div. 5, ch. 2.5, commencing with 71801; 71835(n) (nurse assistant training program modules and hours)\", \"what_it_governs\": \"The 16 training modules and their mandatory theory and suggested clinical hours. CDPH cites this section by number for the hours breakdown: 'California Code of Regulations (CCR) Title 22, Section 71835(n) specifies the mandatory theory and suggested clinical hours for each module', and every CDPH CNA form closes by citing 'California Code of Regulations, Title 22, commencing with §71801.' CDPH links Title 22 through a commercial regulation host rather than a state-run one, and the section text was not read for this page. No sentence of Title 22 is quoted on this page.\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx\"}, {\"citation\": \"42 C.F.R. part 483 (federal requirements for long term care facilities), as cited by CDPH\", \"what_it_governs\": \"The federal nurse aide training, competency evaluation and registry frame that California's program implements. CDPH's forms cite 'Code of Federal Regulations Title 42, Chapter IV, commencing with §483.13' and the CNA page links 42 C.F.R. part 483 on eCFR. The federal text was not read for this page.\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx\"}]",
   "exam_vendor": "Three CDPH-approved testing vendors, and the candidate uses one of them. CDPH publishes the list on its CNA Testing Vendors page: (1) D&S DIVERSIFIED technologies (D&SDT)-HEADMASTER, LLP, PO Box 6609, Helena, MT 59604, (888) 401-0462, California@hdmaster.com, operating as 'HD Master California Nurse Aide Testing Services'; (2) Credentia nurse aide LLC, 1025 Greenwood Blvd. Suite 401, Lake Mary, FL 32746, (888) 204-6249; and (3) regional testing center, 15744 Golden West Street, Forum I (Room 112A), Huntington Beach, CA 92647, (714) 895-8708, rtc@cccd.edu — a community-college-based test centre, the only one of the three physically in California. CDPH's own FAQ names the vendor choices to candidates as 'Credentia, Headmaster or National Nurse Aide Assessment Program' (NNAAP being the exam brand Credentia administers). CDPH refers exam disputes to the vendor: 'Please contact the testing vendor directly for issues pertaining to the exam results.' The vendors are named here because CDPH names and links them; they are not ranked or recommended, and a candidate does not choose freely — availability depends on the training program and test site.",
   "training_hours": "160 hours minimum: 60 classroom theory + 100 supervised clinical. Both the statute and CDPH state it. Health & Safety Code 1337.3(c) — 'Notwithstanding Section 1337.1, the approved training program shall consist of at least the following: (1) A 16-hour orientation program to be given to newly employed nurse assistants prior to providing direct patient care, and consistent with federal training requirements... (2)(a) a precertification training program consisting of at least 60 classroom hours of training on basic nursing skills, patient safety and rights, the social and psychological problems of patients, and elder abuse recognition and reporting... (B) In addition to the 60 classroom hours of training required under subparagraph (A), the precertification program shall also consist of 100 hours of supervised and on-the-job training clinical practice.' CDPH says the same to program applicants: 'California requires 160 hours of training to complete the program. The minimum number classroom theory training is 60 hours and 100 hours of supervised clinical training is required', pointing to 'California Code of Regulations (CCR) Title 22, Section 71835(n)' for the mandatory theory and suggested clinical hours per module (16 modules). What is carved out of the 60: at least 2 hours on 'the special needs of persons with developmental and mental disorders, including intellectual disability, cerebral palsy, epilepsy, dementia, Parkinson's disease, and mental illness'; at least 2 more hours on 'the special needs of persons with Alzheimer's disease and related dementias'; 'a minimum of six hours of instruction on preventing, recognizing, and reporting instances of resident abuse'; and 'a minimum of one hour of instruction on preventing, recognizing, and reporting residents' rights violations' (1337.1(e)(1), 1337.3(c)(3)). What is carved out of the 100: 'At least 4 hours of the 100 hours of supervised clinical training shall address the special needs of persons with developmental and mental disorders, including intellectual disability, cerebral palsy, epilepsy, Alzheimer's disease and related dementias, and Parkinson's disease' (1337.3(c)(4)). The 16 introductory hours: CDPH requires 16 hours before any resident contact, covering 'Communication and interpersonal skills; Infection control; Safety and emergency procedures including the Heimlich maneuver; Promoting the independence of patients/residents; Respecting the rights of patients/residents', and states that 'This requirement is met if all theory components of the following modules are taught prior to clinical training; Modules 1,2,3,4,5,6,12,14.' Lab time is not training time: 'Lab hours, aka \"Skills Lab\" may be included the curriculum, but cannot be counted towards the classroom or clinical hour requirements', and 'Laboratory time does not count as part of the required 160 training hours' — CDPH nonetheless recommends adding lab hours for practice. Lunch and breaks are also excluded. Online theory is allowed: 'A health facility, educational institution, or local agency may conduct the 60 classroom hours of training in an online or distance learning course format, as approved by the department' (1337.3(c)(2)(A)); 'An online or distance learning nurse assistant training program shall meet the same standards as a traditional, classroom-based program' (1337.3(i)); and an online program 'shall contract with a licensed skilled nursing facility or intermediate care facility for the purpose of coordinating and completing the clinical portion' (1337.3(j)). California therefore sits 85 hours above the federal 75-hour floor.",
   "lapse_rule": "California has three distinct after-expiry states, and the boundary is two years. (1) delinquent — 'Certificate holders who fail to renew prior to the expiration date on the certificate will be placed in a delinquent status. These individuals will not be verifiable online until the applicant meets all the renewal requirements within the most recent two-year certification period. Individuals in a delinquent status may not hold himself or herself out to be a certified nurse assistant and/or home health aide until the certificate is renewed and in active status.' A late renewal also resets the clock: 'Due to the lapse in certification the effective date will be changed to the date the application was renewed.' (2) reactivation by exam — for someone who missed the work or in-service requirement but is within two years of expiry: 'If you are unable to meet renewal requirements and your certificate has not been expired for more than two (2) years, you may reactivate the certificate by taking the Competency Evaluation. To apply for reactivation, please submit this completed Renewal Application (CDPH 283 C), making sure to check the \"yes\" box for question number six (6)... You must successfully pass the evaluation within two (2) years from your certificate's expiration date. Once you have successfully passed the evaluation, maintained criminal record clearance, and the results from the testing vendor have been received, CDPH will issue a current CNA certificate.' Reactivation may be started 'up to six months prior to the expiration date on the certificate' — i.e. before the certificate has even lapsed. (3) expired more than two years — full retraining, no exam-only shortcut: 'My certificate has been expired for more than two years, what do I do to become recertified? To obtain an active certificate, you must re-train through a CDPH-approved CNA training program. You must complete and submit the following to CDPH: an Initial Application (CDPH 283B), upon enrollment in the training program and prior to patient contact and a copy of the Request for Live Scan Service (BCIA 8016) form.' In practice that means the whole 160 hours and the Competency Evaluation again. Note the online-verification consequence, which is what employers actually see: since March 1, 2023 the public registry 'will only display active, denied, suspended and revoked statuses for CNA, HHA and CHT' — so an expired or delinquent certificate simply does not appear.",
   "reciprocity": "California grants reciprocity without retraining and without re-examination, but with a work test and a California Live Scan. CDPH: 'If the CNA certification is active and in good standing on another state's registry, the applicant may qualify for certification in the State of California without taking CNA training or the Competency Evaluation.' What the applicant files (CDPH 283E, the Equivalency/Reciprocity application): a copy of the state-issued certificate; 'Proof of work (paystub or W2) showing the CNA has provided nursing or nursing-related services in a facility to residents for compensation within the last two (2) years (not required for those who received their initial certification from another state within the last two (2) years)'; a completed Request for Live Scan Service (BCIA 8016) 'completed in California' — and CDPH is explicit that 'The live scan must be completed in the State of California', with out-of-state applicants allowed to send two FD-258 fingerprint cards plus the $32.00 Department of Justice check instead; and a Verification of Current Nurse Assistant Certification (CDPH 931) 'which must be completed by the applicant and submitted by the endorsing state agency.' The CDPH 931 is conditional: 'Do I have to submit the CDPH 931 if my certificate is verifiable online? No, if your certificate is verifiable online the CDPH 931 is not required, unless requested by the Department.' The work proof is where applications fail: 'Staffing agencies or in home care are not an acceptable work setting in order to qualify for reciprocity to California... If you work in a facility but are paid through a staffing agency you may submit a letter from the facility stating that you have worked there under the supervision of a licensed health professional, the title of the position and dates.' Reciprocity applications must be mailed — unlike initial and renewal applications, CDPH's reciprocity FAQ says only 'You may submit mail in your application package to' the HPCTS address. California also publishes guidance for CNAs transferring out to another state (a separate FAQ section), and the CDPH 931 is the form other states' agencies use to verify a California certificate.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"CDPH — Certified Nurse Assistant (the program's home page). Establishes the responsible unit ('The Healthcare Workforce Branch (HWB), Healthcare Professional Certification and Training Section (HPCTS) is primarily responsible for the certification of nurse assistants by ensuring applicants adhere to the California Health and Safety Code, Section 1337-1338.5'), the OASYS online renewal announcement, the complete CNA form set (283A, 283B, 283C, 283E, 929, 931, 318, BCIA 8016), the verification link, the state and federal citations, the Certification Period Calculator, and the HPCTS mailing address, phone (916) 327-2445 and email cna@cdph.ca.gov.\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx\"}, {\"label\": \"CDPH — Certified Nurse Assistant Frequently Asked Questions (hub page linking ten topic pages: Initial, Equivalency, Reciprocity into California, Reciprocity to another state, Renewal, In-Service Training/CEUs, Work Requirement, Reactivation, Testing Vendors, Miscellaneous). Establishes the three eligibility conditions including 'Be at least sixteen (16) years of age'; the enrolment-time application rule and the 1338.5(2)(A) quote; 'you must specifically live-scan for the California Department of Public Health'; 'You may work up to 120 days as a Nurse Assistant while certification requirements are pending'; the two-birthdays certification period with a worked example; 'What are the processing fees? There are no processing fees for your application'; the acceptable and unacceptable work settings; 'No, IHSS is considered private duty'; the reactivation rules and the six-month early window; the more-than-two-years retraining rule; the reciprocity requirements including 'The live scan must be completed in the State of California' and the CDPH 931 conditional; and 'You must have an active CNA certificate to represent yourself as a CNA.'\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA-FAQ.aspx\"}, {\"label\": \"CDPH — Nurse Assistant Training Program Applicants. Establishes 'California requires 160 hours of training to complete the program. The minimum number classroom theory training is 60 hours and 100 hours of supervised clinical training is required'; the pointer to CCR Title 22 section 71835(n) and the sixteen modules; the 16 hours of state and federal required training before direct resident contact and the five topics; 'This requirement is met if all theory components of the following modules are taught prior to clinical training; Modules 1,2,3,4,5,6,12,14'; 'Lab hours, aka \\\"Skills Lab\\\" may be included the curriculum, but cannot be counted towards the classroom or clinical hour requirements' and 'Laboratory time does not count as part of the required 160 training hours'; the make-up-hour-for-hour rule; the RN Program Director's attestation on the CDPH 283B; and the NATP instructor qualification requirements.\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/Nurse-Assistant-Training-Program-Applicants.aspx\"}, {\"label\": \"CDPH — CNA Testing Vendors. Establishes the three CDPH-approved testing vendors with their addresses and phone numbers: D&S Diversified Technologies (D&SDT)-Headmaster, LLP (Helena, MT, (888) 401-0462, California@hdmaster.com, 'HD Master California Nurse Aide Testing Services'); Credentia Nurse Aide LLC (Lake Mary, FL, (888) 204-6249); and Regional Testing Center (Golden West College, Huntington Beach, CA, (714) 895-8708, rtc@cccd.edu).\", \"url\": \"https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA-Testing-Vendors.aspx\"}, {\"label\": \"CDPH 283B (01/22) — Certified Nurse Assistant Initial Application (PDF). Establishes the submission point ('upon enrollment in the program and before patient contact'), the Live Scan / FD-258 plus $32.00 Department of Justice alternative, the conviction and adverse-action disclosure questions, the RN training-program certification block, the two-birthdays certification statement, the 60-day address/name change duty, and the closing citation to 'Health and Safety Code commencing with §1337 through 1338.5, 1725 through 1742 and Code of Federal Regulations Title 42, Chapter IV, commencing with §483.13 and California Code of Regulations, Title 22, commencing with §71801.'\", \"url\": \"https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph283b.pdf\"}, {\"label\": \"CDPH 283C (7/2024) — Certified Nurse Assistant and/or Home Health Aide Renewal Application (PDF). Establishes the three CNA renewal conditions, the 48-hour in-service/CEU rule with the 12-per-year minimum and 24-hour online cap, the employment-listing requirement, the reactivation question 6 and its two-year window, the delinquent-status rule ('will not be verifiable online... may not hold himself or herself out to be a certified nurse assistant'), the reset of the effective date after a lapse, and the HHA contrast (24 hours, four-year renewal window, no online CEUs).\", \"url\": \"https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph283c.pdf\"}, {\"label\": \"CDPH 283A (5/2024) — Certified Nurse Assistant / Home Health Aide In-Service Training / Continuing Education Units (PDF). Establishes 'CNAs: Must obtain forty-eight (48) hours of In-Service Training/CEUs within the certification period', the 12-hour-per-year minimum and 24-hour online maximum, the NAC# requirement for CEU providers, the semester/quarter unit conversions (15 and 10 hours), the 26-of-40 HHA program credit, 'Training less than 50 minutes increments cannot be counted', the paid-attendance statement, the four-year retention duty, and the worked example of the birthday-based certification period.\", \"url\": \"https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph283a.pdf\"}, {\"label\": \"CDPH 283E (05/22) — Certified Nurse Assistant Equivalency/Reciprocity Application (PDF). Establishes the equivalency route for RN/LVN/psychiatric technician students and graduates, military medical training and foreign license holders ('may not have to take further training and may qualify to take the Competency Evaluation'), the sealed-transcript and DD-214 rules, and the reciprocity route ('may qualify for certification in the State of California without taking CNA training or the Competency Evaluation') with its certificate copy, two-year proof-of-work test, Live Scan or $32 FD-258 cards, and CDPH 931 from the endorsing state agency.\", \"url\": \"https://www.cdph.ca.gov/CDPH%20Document%20Library/ControlledForms/cdph283e.pdf\"}, {\"label\": \"California Health & Safety Code 1337 (official text, California Legislative Information). Establishes the definitions of nurse assistant and certified nurse assistant, the settings the article does not apply to, and the biannual criminal-record-clearance rule that applies regardless of setting.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.&lawCode=HSC\"}, {\"label\": \"California Health & Safety Code 1337.1 (official text). Establishes the 60 classroom hours and 100 supervised clinical hours, the dementia/developmental-disability content minimums, the six-hour abuse-prevention and one-hour residents'-rights instruction inside the 60, and the four-hour abuse-prevention requirement inside recurring in-service hours.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.1.&lawCode=HSC\"}, {\"label\": \"California Health & Safety Code 1337.3 (official text, as amended by SB 862, Stats. 2025 ch. 243, effective January 1, 2026). Establishes the 16-hour orientation and the 60+100 hour program, the 60 percent program pass-rate floor, the Spanish competency-examination vendor solicitation deadline of December 31, 2025, the July 1, 2029 published-list duty, the church-or-denomination exemption, and the online/distance-learning standards.\", \"url\": \"https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=1337.3.&lawCode=HSC\"}, {\"label\": \"CDPH — L&C Certification Verification search page (the public lookup for CNA, HHA, CHT and NHA credentials). Establishes the search fields, the 'Database Last Updated' stamp, and the March 1, 2023 change limiting the online registry to active, denied, suspended and revoked statuses.\", \"url\": \"https://cvl.cdph.ca.gov/SearchPage.aspx\"}, {\"label\": \"D&S Diversified Technologies (D&SDT)-Headmaster — California Nurse Aide Testing Services home page, linked by CDPH from its CNA Testing Vendors page. Establishes this vendor's current testing fees ('EFFECTIVE 3-1-2026: Testing fees price increase: Knowledge Exam $40, Audio Version of the Knowledge Exam $45, Skills Test $100'), the existence of an audio version and remote proctoring of the knowledge exam, the California Candidate Handbook 'Updates Effective 3-1-2026', and that training programs and sponsoring facilities can pay candidates' testing fees.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/California/CA_CNA_Home.htm\"}]",
   "page_url": "https://licensingatlas.com/cna/ca-cna/"
  },
  {
   "page_id": "co-cna",
   "state": "Colorado",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Colorado State Board of Nursing — Division of Professions and Occupations, Colorado Department of Regulatory Agencies (DORA)",
   "board_url": "https://dpo.colorado.gov/Nursing",
   "application_url": "https://dpo.colorado.gov/Nursing/Applications",
   "renewal_cycle": "Biennial, on a fixed statewide date: 'All Certified Nurse Aides expire on January 31 of odd-numbered years', regardless of when the certificate was issued. New applicants get a stub period rather than a short first term — the Division applies a bump: 'All new applicants who are issued a license within 120 days of the upcoming renewal expiration date will be issued a license with the next expiration date.' Renewals open roughly four to five weeks before expiry. What renewal requires is work, attested: Rule 1.10(F)(2) — 'A nurse aide must attest that she/he has received monetary compensation for performing at least eight hours of nursing care activities during the twenty-four months prior to the renewal or reinstatement application date. This attestation serves as proof of this requirement.' Nothing is uploaded; the attestation is the proof, and the same attestation on a reinstatement application 'serves as the verification of the eight hours of compensated nursing care activities' (Rule 1.10(F)(6)). The Division's own guide confirms the work may be done anywhere: an applicant attests to 'Having performed nursing care activities for monetary compensation with an active certificate, in any state or territory of the United States, for at least 8 hours within the last 24 months.' There is a sixty-day grace period, and it is the hinge: 'A certificate that is not renewed by the nurse aide within the renewal period including the sixty day grace period will be subject to reinstatement requirements' (Rule 1.10(F)(1)(b)). A renewal filed after expiry but inside the grace period may be charged a late fee. Proof of renewal in the meantime is practical rather than formal: 'The certificate holder's online renewal confirmation or a receipt from the Board will be considered as proof of renewal until the renewed certificate is issued.' If the eight hours cannot be attested, renewal is still possible but the exam substitutes for the work: Rule 1.10(F)(5)(a) requires the renewal application, the fee, and 'Evidence that the nurse aide has passed the Board's Competency evaluation within the past twenty-four months.' No continuing education is required at any point.",
   "ce_hours": "None. Colorado requires no continuing education of certified nurse aides. Rule 1.10(F), which sets out the requirements for renewal and reinstatement in full, conditions renewal on the application, the fee, and an attestation of eight compensated hours of nursing care activities in the preceding 24 months — and on nothing else. C.R.S. 12-255-202 through 12-255-205 impose no education condition after certification, and the Board's continuing education rule, Rule 1.23, is written for licensed nurses rather than for nurse aides. Sources checked: the whole of 3 CCR 716-1 including Rules 1.10, 1.11, 1.17, 1.18 and 1.23; C.R.S. article 255 part 2; the Board's Nursing Applications page; its Nursing FAQ; and the Board's Certified Nurse Aide Licensing Guide. What Colorado substitutes for continuing education is an annual competence check by a nurse, and it is a condition of practising the expanded scope rather than of holding the certificate: Rule 1.10(C)(5) defines 'Continued Competence' as the CNA's ability to perform the expanded-scope tasks 'with reasonable skill and safety to a client, as deemed by the RN's direct observation of the CNA's clinical performance of the task to occur not less than annually after initially being deemed competent.' So a Colorado CNA who performs tube feedings, suppositories, oxygen administration, presorted medication placement or ostomy care must be re-observed by a registered nurse at least once a year — but nothing about that is filed with the Board, and it does not appear on the renewal.",
   "exam": "Two parts, both required. Rule 1.10(C)(3) defines the competency evaluation as 'the evaluation instrument approved by the Board consisting of both a written and a manual skills component', and the statute requires that 'All applicants except those certified by endorsement shall pass a clinical competency evaluation. The evaluation shall be in a written or oral form' covering basic nursing skills, personal care skills, recognition of mental health and social services needs, basic restorative services, and resident or patient rights. Written — per the vendor's Colorado handbook: 'The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes are left to finish.' Answers go on a separate answer sheet: 'Markings in the test booklet will not be accepted as answers.' Oral — for candidates who have difficulty reading English: 'The Oral Examination includes sixty (60) multiple-choice questions plus ten (10) reading comprehension/word recognition questions', requested at registration. A Spanish candidate handbook is published alongside the English one. Skills — 'For the Skills portion of your test, you will be asked to perform five (5) randomly selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator.' Candidates must arrive 30 minutes early for both parts, bring two forms of current signed identification with one photograph, three sharpened No. 2 pencils, an eraser and a watch with a second hand, and 'If you are not logged in ten minutes prior to the exam start time, or you do not bring all of your required materials, you will not be allowed to test and your fees will not be refunded' — and an identification failure 'will count as one of your 3 opportunities to test'. Online remotely proctored testing is offered, with a 360-degree room scan through a separate app. Results and retests: applicants 'are informed in writing regarding the results of the Competency evaluation', and the Board 'releases Competency evaluation results only to the applicant or the nurse aide with written authorization' (Rule 1.10(D)(5)-(6)). Rescheduling is allowed once and requires at least nine business days' notice; 'Once payment of exam fees is received, NO REFUNDS WILL BE ISSUED.' The three-strike consequence: failing any component three times means repeating a nurse aide training programme 'before being eligible to apply for nurse aide certification or to take the Competency evaluation at any time in the future.' One protection for the candidate: 'In the event that applicant examination materials are lost or destroyed through circumstances beyond the control of the Board, the applicant will be required to retake the Competency evaluation' — the retake is required, but it is the Board's rule rather than a vendor policy.",
   "fees": "Colorado charges a state application fee, but does not publish the amount on any page read. The statute requires one: every applicant, 'whether qualifying by competency evaluation or by endorsement, shall submit the application on forms provided by the board' and 'shall include with the application... an application fee established pursuant to section 12-20-105' (C.R.S. 12-255-202). Two features of that fee are unusual and are stated in the same section: 'The board may reduce the application fee if federal funds are available' — which follows from the programme being federally funded under C.R.S. 12-255-201(2) — and 'The fee is not subject to the provisions of section 12-20-104.' Every application route repeats the requirement without a figure: the Division's Certified Nurse Aide Licensing Guide tells endorsement, reinstatement and medication-aide applicants to 'Submit payment of the required application fee via credit card. All fees are non-refundable and non-transferable', and Rule 1.10 conditions renewal, reinstatement and re-examination on 'Payment of the required fee' throughout. Where the number would be, and why it is not here: the Division's own Nursing Applications page says 'All fees and mailing instructions are available on the respective applications and forms', and the applications are filed inside the DPO Online Services system where the fee is shown at checkout. The two Division pages that would carry the CNA-specific fee list — the Board's CNA Applications and Forms page and its Licensing Services page — both return 'Access denied. You are not authorized to access this page' to the public, and did so when checked again from a second network location on August 16, 2026, so the figure could not be read from a state source and is deliberately not stated here. A late fee exists but its amount is likewise unpublished: 'Nurse aide certificate renewal applications postmarked after the certificate's expiration date and prior to the end of the grace period, may be assessed a late fee' (Rule 1.10(F)(1)(a)(1)). Separate payments are required for each renewal application. Examination fees are the vendor's and are also unpublished in the candidate handbook: 'You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test. Payment must be made in the form of a credit card, debit card single-use card or electronic voucher. Vouchers can be purchased by the training programs. Fees are not refundable.' The Colorado handbook, unlike the same vendor's handbooks for some other states, prints no fee table at all. 'Once payment of exam fees is received, NO REFUNDS WILL BE ISSUED.' Training cost is set by the approved programme and is not published by the Board.",
   "legal_basis": "[{\"citation\": \"C.R.S. Title 12, Article 255, Part 2 (Nurse Aides) — the Nurse and Nurse Aide Practice Act, added with relocations by HB 20-1183 effective July 1, 2020\", \"what_it_governs\": \"The whole Colorado nurse aide scheme: the certification programme and its federal Medicaid and Medicare funding (12-255-201); the application and fee (12-255-202); certification by competency evaluation (12-255-203, 12-255-205) including the requirement that evaluations be held at least four times a year and cover basic nursing skills, personal care skills, mental health and social services needs, basic restorative services and resident or patient rights; certification by endorsement through the occupational credential portability program (12-255-204); the expanded scope of practice and the registered nurse's competence determination (12-255-206); the seven-member nurse aide advisory committee (12-255-207); medication aides (12-255-208); grounds for discipline (12-255-209); withholding or denial of certification (12-255-210); mental and physical competency (12-255-211); disciplinary proceedings (12-255-212); surrender of a certificate (12-255-213); the exclusions (12-255-214); and unauthorized practice as a class 2 misdemeanor (12-255-215).\", \"url\": \"https://drive.google.com/file/d/0B-K5DhxXxJZbelVEMkEwa29TYjQ/view?usp=sharing&resourcekey=0-7ZoS72YGvY5OpDrHpFvscQ\"}, {\"citation\": \"C.R.S. 12-255-104(3.3) (definition of 'certified nurse aide')\", \"what_it_governs\": \"The reserved title: 'Only a person who holds a certificate to practice as a nurse aide in this state pursuant to part 2 of this article 255 has the right to use the title \\\"certified nurse aide\\\" and its abbreviation, \\\"C.N.A.\\\"'\", \"url\": \"https://drive.google.com/file/d/0B-K5DhxXxJZbelVEMkEwa29TYjQ/view?usp=sharing&resourcekey=0-7ZoS72YGvY5OpDrHpFvscQ\"}, {\"citation\": \"3 CCR 716-1, Rule 1.10 (Rules and Regulations for Certification as a Nurse Aide), Colorado State Board of Nursing; current version effective 03/17/2026\", \"what_it_governs\": \"Certification by examination and by endorsement, the delegation of examination, issuance and renewal authority to the Executive Officer, the deeming of nursing and psychiatric technician programmes as nurse aide training programmes, the foreign-education and military routes, the two-year completion window and the permanent three-failure bar, renewal and reinstatement including the eight-hour compensated-work attestation and the sixty-day grace period, the one-year application purge, the thirty-day name and address duties, military-spouse temporary certification, and the CNA scope of practice and continued-competence standard.\", \"url\": \"https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12453&fileName=3%20CCR%20716-1\"}, {\"citation\": \"3 CCR 716-1, Rule 1.11 (Rules and Regulations for Approval of Nurse Aide Training Programs)\", \"what_it_governs\": \"The 75-hour curriculum minimum with no less than 16 hours of classroom instruction and no less than 16 hours of clinical instruction under the direct supervision of an RN or LPN, the definition of the pre-clinical period as the first 16 hours before any direct client contact, the required curriculum content, programme approval procedures, and the duty to report significant changes — including changes to 'the number of hours of instruction required for successful completion of the program' — to the Board before implementation.\", \"url\": \"https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12453&fileName=3%20CCR%20716-1\"}, {\"citation\": \"3 CCR 716-1, Rule 1.17 (Rules and Regulations for the Colorado Certified Nurse Aide Registry)\", \"what_it_governs\": \"The registry's contents; the definitions of finding, abuse, neglect and misappropriation; placement of a finding within ten days of the final finding; the mandatory-removal grounds; the neglect-only removal petition with its five-year (harm) and three-year (no harm or verbal abuse) waiting periods, the singular-occurrence exception and the one-year floor; and the Board's ninety-day review.\", \"url\": \"https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12453&fileName=3%20CCR%20716-1\"}, {\"citation\": \"3 CCR 716-1, Rule 1.18 (Rules and Regulations for the Certified Nurse Aide in Relation to Medication Aide Authority), authority C.R.S. 12-255-208(1)\", \"what_it_governs\": \"The separate Medication Aide Authority layered on a CNA certificate — named here only to mark the boundary of this page, which does not cover it.\", \"url\": \"https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12453&fileName=3%20CCR%20716-1\"}, {\"citation\": \"C.R.S. 12-20-105 (fees), 12-20-202 (occupational credential portability program and temporary licenses) and 12-20-102 (renewal), as applied by the nurse aide rules\", \"what_it_governs\": \"The general Division statutes the nurse aide scheme runs on: the authority under which the application fee is set, the portability programme that endorsement now flows through, and the renewal framework. Their texts were not read as of August 16, 2026; each is cited as the statute and rules cite it, and nothing is quoted from them.\", \"url\": \"https://drive.google.com/file/d/0B-K5DhxXxJZbelVEMkEwa29TYjQ/view?usp=sharing&resourcekey=0-7ZoS72YGvY5OpDrHpFvscQ\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal 75-clock-hour floor and 16 hours of supervised practical training that Colorado's Rule 1.11 matches, and the prohibition of charges to a nurse aide employed by or holding an offer from a facility. Colorado's own rules reference the federal frame as 'the requirements of the Omnibus Budget Reconciliation Act of 1987' rather than by regulation number.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP) for the Colorado State Board of Nursing, and Colorado goes further than most states by letting the vendor take the application itself: 'The State Board of Nursing has authorized Credentia, to process its applications for Initial Licensure by Examination Method. Instructions on how to register and complete the NNAAP Nurse Aide Exam and apply for a Certified Nurse Aide by Examination are available on the Credentia system.' The Board's Certified Nurse Aide Licensing Guide points candidates to the same place — 'If becoming certified by examination, please go to the following website for information how to take the test: Colorado CNA Evaluation: https://credentia.com/test-takers/co/' — and adds that 'Colorado's currently approved test is offered through the exam vendor.' The rule names no company. Rule 1.10(D)(1)-(2) says only that 'The Board will review and may accept a Competency evaluation for nurse aides' and that 'The contract for the use of the Competency evaluation will be approved by the Executive Officer or designee', so the vendor is a contract the Board can change without a rulemaking. The statute fixes the frequency and the subject matter instead: competency evaluations 'shall be held at least four times per year' (C.R.S. 12-255-205(2)), which Rule 1.10(D)(3) restates as 'administered at least quarterly', and the evaluation must cover basic nursing skills, personal care skills, recognition of mental health and social services needs, basic restorative services, and resident or patient rights (C.R.S. 12-255-205(1)). Credentia's Colorado handbook describes its own role as reporting 'the NNAAP examination to the Board' and states that it 'also processes applications, schedules examinations and administers the tests.' The Medication Aide Authority uses a different examination from the same vendor.",
   "training_hours": "75 hours minimum, with a 16/16 floor inside it — Colorado sits exactly on the federal minimum in total but structures it more tightly. Rule 1.11(E)(2)(a): the curriculum shall provide 'A minimum of seventy-five hours of instruction to include no less than 16 hours of classroom instruction and no less than sixteen hours of clinical instruction under the direct supervision of an RN or LPN.' The first block is fenced off from patients: 'At least the first sixteen hours of the required seventy-five hours shall be considered pre-clinical', and Rule 1.11(B)(9) defines pre-clinical as 'The first portion of the approved program that occurs prior to any direct contact with a Client that must be no less than sixteen hours', covering communications and interpersonal skills, infection control, and safety and emergency procedures including the Heimlich manoeuvre, among the areas the rule lists. What the course must teach is set out in Rule 1.11 and then imported verbatim into the CNA's own scope of practice by Rule 1.10(I)(2): basic nursing skills including caring for clients when death is imminent, taking and recording vital signs, measuring and recording height and weight, caring for the client's environment, measuring and recording intake and output, and recognising and reporting abnormal signs and symptoms of common conditions related to all body systems; personal care skills including bathing, grooming and mouth care, dressing, toileting, assisting with eating and hydration, proper feeding techniques, skin care, and transferring, positioning and turning; and skills meeting psychosocial and mental health needs. A programme must tell the Board before it changes its hours: Rule 1.11 lists 'The number of hours of instruction required for successful completion of the program' among the significant changes that 'shall be reported to the Board prior to implementation', alongside changes of coordinator or primary instructor, terminal competencies, curriculum order and composition, programme status and clinical sites. The Board publishes its own list of approved programmes — its FAQ answers 'What Nurse Aide training programs are approved by the Board?' with 'The Board maintains a list of the approved nurse aide training programs on its website.'",
   "lapse_rule": "Colorado's ladder has three rungs and the second one is where most aides land. Inside the sixty-day grace period: renew normally, possibly with a late fee. Expired less than two years: reinstatement on 'A Board approved reinstatement application signed by the nurse aide' and 'Payment of the required fee' (Rule 1.10(F)(3)) — plus the same attestation of eight compensated hours of nursing care activities in the preceding 24 months, since Rule 1.10(F)(2) applies to reinstatement as well as renewal. Where those hours cannot be attested, the exam substitutes: reinstatement then needs 'Evidence that the nurse aide has passed the Board's Competency evaluation within the past twenty-four months' (Rule 1.10(F)(5)(b)). Expired more than two years: reinstatement only by re-taking and passing the exam — 'To reinstate a certificate that has been expired for more than two years, the applicant must re-take and pass the Competency evaluation and submit: a. A Board approved examination application; and b. Payment of the required fee' (Rule 1.10(F)(4), repeated at (F)(5)(c) for the written and manual skills components). The Division's Licensing Guide adds a practical requirement for reinstatement applicants: 'Detail any work as an NA in Colorado since your license has been expired (this could include work in a long-term care facility or home care agency).' Discipline and registry findings are a separate track. Rule 1.17 governs findings of abuse, neglect and misappropriation, each defined in the rule — abuse as 'the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish', neglect as 'failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness and to promote health and wellness', misappropriation as 'the deliberate misplacement, exploitation, or wrongful (temporary or permanent) use of a patient's belongings or money or facility property'. A finding goes on the registry 'within ten days of the final finding' and may also rest on a criminal conviction. Removal is narrow and timed. A finding must be removed only where it 'has been determined to be in error', where the aide 'has been found not guilty of the offense in a court of law if the conviction was the basis of the placement', or on proof of death. Otherwise only a finding of neglect may be removed, on the aide's request, and the waiting periods are express: 'Five years from the date of the final finding in cases of neglect in which harm to the patient resulted' and 'Three years from the date of the final finding in cases of neglect where no harm occurred or verbal abuse' — unless the request rests on evidence that the behaviour 'was not a part of a pattern of abusive behavior or neglect and the neglect was a singular occurrence', in which case it may be made at any time, though no determination on that ground will be made 'prior to the expiration of the one-year period beginning on the date on which the name of the certified nurse aide was added to the registry.' A request must include evidence both that the behaviour was a singular occurrence and 'Evidence of rehabilitation', and the Board reviews it within ninety days. A certificate may also be surrendered before an investigation or hearing under C.R.S. 12-255-213.",
   "reciprocity": "Colorado calls it certification by endorsement and runs it through a general statute rather than a nurse-aide rule: 'An applicant may obtain certification by endorsement if the applicant satisfies the requirements of the occupational credential portability program' (C.R.S. 12-255-204, as amended by the Red Tape Reduction Act in 2020). Rule 1.10(E) states the test: under the Occupational Credential Portability Program at C.R.S. 12-20-202(3), an applicant 'is entitled to certification as a nurse aide by endorsement in Colorado if the applicant is currently certified in good standing in another state or US territory or through the federal government, or holds a military occupational specialty', and has submitted satisfactory proof under penalty of perjury that the applicant either 'Has substantially equivalent education, experience, or credentials that are required by Article 255 of Title 12' OR 'Has held for at least one year a current and valid certificate as a nurse aide in a jurisdiction with a scope of practice that is substantially similar to the scope of practice for nurse aides as specified in Article 255 of Title 12' — and that the applicant 'has not committed an act that would be grounds for disciplinary action'. The application is filed on the current Board-approved form with the fee. No Colorado examination is required on this route: the statute exempts endorsement applicants from the competency evaluation ('All applicants except those certified by endorsement shall pass a clinical competency evaluation'), and Rule 1.10(C)(8) defines endorsement as the Board's determination 'that the applicant is certified to practice as a nurse aide by another state or territory of the United States with requirements that are essentially similar to the requirements of Colorado.' The Board may deny endorsement only after 'notice and opportunity for a hearing' and only on a preponderance of evidence that the applicant lacks substantially equivalent education, experience or credentials, or has committed an act that would be grounds for discipline. What the applicant uploads, per the Division's Certified Nurse Aide Licensing Guide: the application fee by credit card, information on 'all other healthcare licenses held anywhere other than Colorado', 'verification of your CNA license in another state', name-change documentation where applicable, answers to general and criminal history screening questions with supporting documents, and a completed Healthcare Professions Profile. A candidate whose out-of-state certificate has lapsed goes the other way — the exam vendor lists 'NURSE AIDE WHO WAS TRAINED IN ANOTHER STATE AND DOES NOT HOLD A CURRENT NURSE AIDE CERTIFICATE: You must provide proof that you completed a state approved nurse aide training program', and then sit the Colorado examination within two years of the application. A separate telehealth credential exists for an out-of-state CNA who will practise into Colorado remotely, requiring an active out-of-state certification, an attestation to practise telehealth only, and a Colorado registered agent.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Colorado State Board of Nursing — Nursing Homepage (Division of Professions and Occupations). The programme's home page. Establishes the Board's address and contacts (1560 Broadway, Suite 1350, Denver, CO 80202; 303-894-7800; dora_nursingboard@state.co.us for programme and discipline questions, dora_dpo_licensing@state.co.us for applications and renewals); the existence of a Nurse Aide Advisory Committee with published meeting minutes; the links to applications, the practice act, the rules, the FAQ, the license lookup and the downloadable licensee and discipline list; and the notice that 'The Colorado Office of Policy, Research and Regulatory Reform is currently conducting a sunset review of the Board of Nursing and Nurse Aide Certification. Analysis is performed to determine if these programs are necessary and should be continued, modified, or repealed.'\", \"url\": \"https://dpo.colorado.gov/Nursing\"}, {\"label\": \"Colorado Nursing Applications and Forms (Division of Professions and Occupations). Establishes that 'The State Board of Nursing has authorized Credentia, to process its applications for Initial Licensure by Examination Method'; the four CNA application routes (Initial License by Examination Method via Credentia, Initial License by Endorsement or Telehealth Method, Reinstatement, Renewal) and the Spanish-language application; the separate Medication Aide Authority applications; the Verification of Nurse Aide Certification form; the 120-day new-applicant expiration bump; that renewals open approximately four to five weeks before expiry; and the expiration calendar — 'All Certified Nurse Aides expire on January 31 of odd-numbered years.'\", \"url\": \"https://dpo.colorado.gov/Nursing/Applications\"}, {\"label\": \"Certified Nurse Aide Licensing Guide (Colorado Division of Professions and Occupations). Establishes that 'The practice of working as a certified nurse aide (CNA) is regulated by the Colorado Department of Regulatory Agencies (DORA). You must be licensed by DORA to work as a certified nurse aide (CNA) in Colorado. Please note that applying is no guarantee of licensure and all applications are reviewed on a case-by-case basis'; the endorsement checklist (fee by credit card, other healthcare licenses, verification of the out-of-state CNA license, name-change documentation, criminal history screening, Healthcare Professions Profile); the three telehealth conditions including the Colorado registered agent; the reinstatement checklist and its two alternative attestations (eight compensated hours in any U.S. state or territory within the last 24 months, or passing both exam parts within the last 24 months); the Medication Aide Authority requirements; and the foreign-trained pathway.\", \"url\": \"https://drive.google.com/file/d/1wZxFyh7G9Hy5Rr8BedN_1kt975xmuAuN/view\"}, {\"label\": \"3 CCR 716-1, Nursing Rules and Regulations (Colorado State Board of Nursing), current version effective 03/17/2026, adopted 01/21/2026, published in the Colorado Register 02/25/2026. The official rule text and the source of every rule quotation on this page — Rule 1.10 (certification as a nurse aide), Rule 1.11 (approval of nurse aide training programs, including the 75-hour minimum and the 16-hour classroom and 16-hour clinical floors), Rule 1.17 (the Certified Nurse Aide Registry and the removal-of-findings process) and Rule 1.18 (Medication Aide Authority).\", \"url\": \"https://www.sos.state.co.us/CCR/GenerateRulePdf.do?ruleVersionId=12453&fileName=3%20CCR%20716-1\"}, {\"label\": \"Code of Colorado Regulations — 3 CCR 716-1 document list (Colorado Secretary of State). The official publication record under C.R.S. 24-4-103(11), showing the current version's effective, adopted and Colorado Register publication dates and eDocket tracking number, and the full archive of prior versions. The page states that 'The PDF document constitutes the official version of the rule and shall govern in all cases.'\", \"url\": \"https://www.sos.state.co.us/CCR/DisplayRule.do?action=ruleinfo&ruleId=2251&deptID=18&agencyID=78&deptName=Department%20of%20Regulatory%20Agencies&agencyName=Board%20of%20Nursing&seriesNum=3%20CCR%20716-1\"}, {\"label\": \"Nurses and Nurse Aides Practice Act, C.R.S. Title 12 Article 255 (Colorado Revised Statutes 2025 printout published by the Colorado State Board of Nursing). The source of every statutory quotation here, including the reserved title at 12-255-104(3.3), the whole of part 2 (12-255-201 through 12-255-215), the expanded scope of practice at 12-255-206, the exclusions at 12-255-214 and the class 2 misdemeanor for unauthorized practice at 12-255-215. The document is headed 'Uncertified Printout Colorado Revised Statutes 2025'.\", \"url\": \"https://drive.google.com/file/d/0B-K5DhxXxJZbelVEMkEwa29TYjQ/view?usp=sharing&resourcekey=0-7ZoS72YGvY5OpDrHpFvscQ\"}, {\"label\": \"Colorado Nursing FAQ (Colorado State Board of Nursing). Establishes that 'The practice of a nurse aide is under the supervision of a physician, podiatrist, professional nurse, licensed practical nurse, or other licensed or certified healthcare professional acting within the scope of his or her practice'; that 'The Colorado Nurse Practice Act and Nurse Aide Act does not prohibit RNs, LPNs or CNAs from caring for family members'; that 'The Board maintains a list of the approved nurse aide training programs on its website'; that 'For Nurse Aides, training programs provide Certificates to successful graduates. Graduates should maintain their original certificates, as the Nurse Aide Training programs only maintain records for two years'; and the foreign-trained answer — 'To work as a Certified Nurse Aide in Colorado you must be certified in Colorado. If you have five semester hours of fundamentals of nursing, or its equivalent on your English-translated transcript, you meet the educational requirements.'\", \"url\": \"https://dpo.colorado.gov/Nursing/FAQ\"}, {\"label\": \"Colorado Nurse Aide Written (or Oral) Examination & Skills Evaluation Candidate Handbook, October 2024 (Credentia, for the Colorado State Board of Nursing). Establishes the NNAAP structure in Colorado (70 written multiple-choice questions in two hours with a fifteen-minute warning; an oral alternative of 60 multiple-choice plus 10 reading comprehension/word recognition questions; five randomly selected skills rated by a Nurse Evaluator); the eligibility routes E-1 to E-11 and the two-year application clock ('you must pass the nurse aide exam within two (2) years (24 months) after Credentia receives your application'); the requirement to pay for both parts at first testing and that 'Fees are not refundable'; the one-time reschedule with nine business days' notice; 'Once payment of exam fees is received, NO REFUNDS WILL BE ISSUED'; the excused-absence grounds; the identification and materials rules and the consequence that an identification failure counts as one of three test opportunities; and the Board's own contact block for registry, endorsement and renewal questions.\", \"url\": \"https://credentia.com/storage/co-handbook_2024.pdf\"}, {\"label\": \"Credentia — Colorado test takers page. The vendor's live Colorado landing page, which the Board's own applications page and Licensing Guide both send candidates to by address for initial certification by examination.\", \"url\": \"https://credentia.com/test-takers/co/\"}, {\"label\": \"Colorado Nursing — Practice Act and Laws (Colorado State Board of Nursing). The Board's own laws page, from which the Nurses and Nurse Aides Practice Act printout is published, together with the Board's scope-of-practice statements.\", \"url\": \"https://dpo.colorado.gov/Nursing/Laws\"}, {\"label\": \"Colorado DORA — Licensee lookup (Division of Professions and Occupations). The public verification tool the Board links as 'Lookup a License/ Licensee' and 'Verify a License'.\", \"url\": \"https://apps.colorado.gov/dora/licensing/Lookup/LicenseLookup.aspx\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR current text). The federal training-programme standard whose 75-clock-hour floor and 16 hours of supervised practical training Colorado's Rule 1.11 matches.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/co-cna/"
  },
  {
   "page_id": "ct-cna",
   "state": "Connecticut",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Connecticut Department of Public Health (DPH) — Practitioner Licensing and Investigations Section, Nurse's Aide Registry",
   "board_url": "https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/nurse-aide-registration",
   "application_url": "https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/route-1---new-cna",
   "renewal_cycle": "Every two years, renewed on work rather than on a fee or a course. DPH: 'To renew a nurse aide certificate, nurse aides must have worked at least one 8-hour shift of paid employment as a nurse aide or in a position providing nursing related services prior to their nurse aide certificate expiring.' The clock is set by the work, not by the calendar: 'Renewals will be effective two years from the last date of reported/verified employment.' 'There is no fee for renewal.' How it is filed: the aide downloads the Nurse Aide Employment Verification Form, completes the nurse aide section, and has the employer complete the employer section, which asks for the facility or agency name and address, the date of hire and the 'Last Reported Date of Employment', with a signed certification by an employer representative. The completed form goes to the Nurse Aide Registry 'by fax at (860) 707-1983, email to dph.nurseaide@ct.gov or mailed to the address located at the bottom of the employment verification form.' Facilities renewing several aides at once 'may use the multiple nurse aides verification form.' The form has a check box for Facility/Agency, Private Duty or Out of State employment, and a private-duty or physician's-office aide must attach 'a description of the specific nurse aide or nursing related duties performed.' What renewal does not produce, in the words of Prometric's Connecticut candidate handbook rather than of DPH: 'You will not receive another certificate at time of renewal. Your original testing certificate is your official certificate.' What blocks renewal: 'If your certificate is flagged for resident abuse, neglect, misappropriation of resident property or Medicaid fraud on the Connecticut Nurse Aide Registry, your certification will not be renewed and you are prohibited from working in a licensed chronic convalescent nursing home.'",
   "ce_hours": "No continuing education is required to renew a Connecticut nurse's aide registration. Renewal is documented paid work — one eight-hour shift in the two-year cycle — and nothing else; no DPH nurse aide page we checked mentions in-service or continuing education as a renewal condition. The Department's own list of 'License Types with Continuing Education Requirements' names 33 professions, from Acupuncturist to Veterinarian, including Licensed Practical Nurse, Registered Nurse, Advanced Practice Registered Nurse and Nursing Home Administrator — and nurse aide is not among them. Neither Conn. Gen. Stat. 20-102ee, which sets the training requirement, nor the nurse's aide provisions of Public Health Code 19-13-D8t(l) imposes a recurring education duty on the individual aide. The two-hour post-traumatic stress and suicide-prevention component added by P.A. 21-46 is part of the 100-hour initial training program, not a renewal obligation.",
   "exam": "Two tests, and neither is a prerequisite for the other: 'The Connecticut Nurse Aide Exam consists of a Clinical Skills Test and a Written (Knowledge) Test. You are not required to pass one test before taking the other. First-time testers must register for both tests.' Written (knowledge) test — 'The Written test consists of 60 multiple-choice questions. You will have 90 minutes to take the test', delivered on computer with a mouse and no computer experience needed. The published content outline weights it: Role of the Nurse Aide 18%, Promotion of Safety 18%, Promotion of Function and Health of Residents 24%, with the remaining domains set out in the handbook's outline. Oral form — 'The Written Test may be taken in an oral form. During an oral test, you will hear the questions read to you while reading and answering questions on the computer. You may replay questions as many times as needed', and the choice must be made on the application: 'This request cannot be made on the day of testing.' Candidates taking the oral form 'do not need to apply for ADA accommodations.' Clinical skills test — computer-assigned and timed: 'For your test, you will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills — Handwashing and Indirect Care', where Indirect Care is 'care related to resident rights and preferences, communication with the resident, resident safety, comfort and needs, and infection control.' 'The time allowed for the Clinical Skills test ranges from 31 minutes to 40 minutes based on the skills you are asked to perform.' 'To pass the Clinical Skills Test, you must pass all five skills. To pass a skill, you are not required to perform the skill perfectly, but you are required to demonstrate competency of the skill.' Corrections are allowed mid-skill if announced and actually performed, but not after the skill ends and not where a safety issue has occurred. Candidates are asked to act as the resident for another candidate, and the handbook lists the twelve skills that may be performed on a resident actor. Language — the state's two own documents disagree and both are recorded. The candidate handbook (revised August 21, 2019) says: 'The Connecticut Nurse Aide Competency Exam is offered only in English. Translators are not permitted and translation dictionaries may not be used during the exam administration.' The current Connecticut Certified Nursing Assistant Examination Application, by contrast, offers four first-time combinations including 'Written Test (Spanish) and Clinical Skills Test (English)' and 'Oral Test (Spanish) and Clinical Skills Test (English)', and Spanish re-test options at the same price as English. The application is the live form a candidate fills in; the handbook is the older document. Attempts — no cap inside the eligibility window: DPH states 'There are no limits as to how many times a candidate can take the examination within the 24 month period', and the handbook confirms 'You must take and pass both the Clinical Skills Test and Written Test within a two-year eligibility period. A testing fee and application are required each time you take a test. You are only required to retake the test you failed.' Results — the written test produces an immediate pass/fail score report on screen; the skills score report is handed over at the test site shortly after the test. 'If you pass both parts of the exam, your Connecticut Nurse Aide Certificate will be mailed to you and your name will be added to the Connecticut CNA Registry. People who are successful typically are listed on the registry within 48 hours.' The certificate is mailed within 15 business days of testing. No numeric passing score for the written test is published in any Connecticut source we checked. Appeals — a written, signed appeal about exam content, registration, scheduling or administration must reach the contractor's Appeals Committee within 60 days of the exam date; 'Faxed appeals will not be accepted because an original signature is required.' Accommodations — documentation of a disability recognized under the ADA is submitted with the application, 'Thirty days' advance notice is required for all testing arrangements', and 'There is no additional charge for these accommodations.'",
   "fees": "The Department of Public Health charges nothing — no application fee and no renewal fee appears on any DPH nurse aide page we checked, and DPH states the renewal side in terms: 'There is no fee for renewal.' Every dollar in this credential is paid to the testing contractor. Two official figures for the same exam, and they disagree. DPH's Route 1 and Route 2 pages state: 'The fee for the examination is $118.' The current Connecticut Certified Nursing Assistant Examination Application published on the Connecticut nurse aide exam page prices the same first-time combination at $125: 'Written Test and Clinical Skills Test $125', 'Written Test (Spanish) and Clinical Skills Test (English) $125', 'Oral Test and Clinical Skills Test $125', 'Oral Test (Spanish) and Clinical Skills Test (English) $125'. The candidate handbook agrees with the application at $125. Both figures are recorded here and attributed; the application is the form a candidate actually submits with payment, and the $118 appears only in DPH's page text. The rest of the schedule, from the current application: re-test Clinical Skills Test only $77; re-test Written Test only $48 (English or Spanish); re-test Oral Test only $48 (English or Spanish), and 'You may select this Route even if you previously took the Written test'; Route 5 (trained and took the state exam in the last 24 months) $55; Route 7 (reciprocity) $55; 'Rescheduling/No Show $20', which 'is required to reschedule an exam appointment with less than five business days' notice, no-shows, late arrivals, or not allowed to test.' The candidate handbook's older schedule differs on that last line — it lists a '$25 to reschedule up to five full working days before your test', 'A full exam fee if you reschedule less than five full working days before your test', plus an Appeals/Handscore fee of $25 and a Processing Fee of $20 — so the reschedule charge is one of the points where handbook and live form part company. Duplicate certificate $15, stated by both DPH ('There is a $15 fee for this service') and the handbook; updating a name or address on the registry itself is free, and only a replacement certificate costs the $15. Optional practice material, priced by the contractor and required by nobody: the Nurse Aide Practice Exam contains 50 questions at '$10' each, and Clinical Skills Readiness tests run '$5 to $7 with a super pack of all skills available for $25.' Payment rules: 'Fees are non-refundable and non-transferrable', personal checks and cash are not accepted, and 'Applications received without proper payment will be returned.' Training cost is set by the approved program and is not published by DPH.",
   "legal_basis": "[{\"citation\": \"Conn. Gen. Stat. ch. 378a (Nurse's Aides), sections 20-102aa through 20-102ff\", \"what_it_governs\": \"The whole Connecticut nurse's aide scheme: the definitions of 'nurse's aide', 'registration' and 'registered nurse's aide' (20-102aa); the Department of Public Health's duty to establish and maintain the registry (20-102bb); complaints, findings of resident abuse, neglect, misappropriation and fraud, the 30-day hearing request and the one-year petition to remove a neglect finding (20-102cc); grounds for denial of registration (20-102dd); the rulemaking mandate and the 100-hour training requirement with its 75/25 subject split and the two-hour post-traumatic stress and suicide-prevention component effective on and after January 1, 2022 (20-102ee); and the limit that a registration authorizes no activity requiring a license under chapter 378 (20-102ff).\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_378a.htm\"}, {\"citation\": \"Conn. Public Health Code 19-13-D8t(l) — Nurse's Aide Training and Employment (regulation of Connecticut state agencies, as published by the Department of Public Health)\", \"what_it_governs\": \"The operating rules behind the statute: the 120-day employment bar and the registry-inquiry duty on facilities; the 100-hour training program with its 75-hour and 25-hour components 'presented in both lecture and clinical settings'; the competency evaluation elements; instructor qualifications and the bar on the director of nurses teaching; the restricted duties of untrained and untested workers; the registry data fields and the recording of findings; the 24-consecutive-month lapse rule; deemed completion for pre-1989 state-sponsored training and for 100 hours of nursing-program instruction; entry of out-of-state registrants; and the single 120-day utilisation period for out-of-state and CGFNS-certified nurses. Note on currency: the copy the Department publishes is stamped 'Current with materials published in Connecticut Law Journal through 4/9/02', so it predates the 2021 statutory amendment to the training requirement.\", \"url\": \"https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/facility_licensing_and_investigations/Nurse_Aide_Training/CNARegulationspdf.pdf\"}, {\"citation\": \"Conn. Public Act 21-46, s. 6 (2021), amending Conn. Gen. Stat. 20-102ee(a), effective July 1, 2021\", \"what_it_governs\": \"The addition of the two-hour post-traumatic stress screening and suicide-prevention component to the nurse's aide training program 'on and after January 1, 2022', together with the list of organisations whose suicide-prevention training qualifies. Recorded from the statute's own history note in Conn. Gen. Stat. ch. 378a; the session law text itself was not read as of August 16, 2026.\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_378a.htm\"}, {\"citation\": \"Conn. Gen. Stat. 19a-88b (referenced by the chapter's own note)\", \"what_it_governs\": \"Renewal of certain professional and occupational licenses, certificates, permits or registrations that become void while the holder is on active duty in the armed forces of the United States. Chapter 378a carries the cross-reference as its opening footnote; the section text itself was not read as of August 16, 2026, and nothing on this page is quoted from it.\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_378a.htm\"}]",
   "exam_vendor": "Prometric, under contract to the Department of Public Health. DPH names it on every testing route — 'the Connecticut CNA examination administered by Prometric' — and the state-approved candidate handbook states the scope of the contract: 'The Connecticut Department of Public Health (DPH) has contracted with Prometric Inc. (Prometric) to develop and administer its Nurse Aide Competency Exam and to manage the Certified Nurse Aide (CNA) Registry.' DPH publishes Prometric's Connecticut nurse aide contact details directly (Prometric, CT Nurse Aide, 7941 Corporate Dr., Nottingham MD 21236, phone 866.499.7485, CTCNA@Prometric.com); the candidate handbook and application give a Middle River, Maryland mailing address (6211 Greenleigh Avenue, Suite 400, Middle River, MD 21220) for applications and appeals. Applications, fees, scheduling, certificates and duplicate certificates all go to Prometric rather than to DPH.",
   "training_hours": "100 clock hours minimum, and Connecticut splits them by subject rather than by classroom-versus-clinical. The statute: 'Such regulations shall require a training program for nurse's aides of not less than one hundred hours. Not less than seventy-five of such hours shall include, but not be limited to, basic nursing skills, personal care skills, care of cognitively impaired residents, recognition of mental health and social service needs, basic restorative services and residents' rights. Not less than twenty-five of such hours shall include, but not be limited to, specialized training in understanding and responding to challenging behaviors related to physical, psychiatric, psychosocial and cognitive disorders' (Conn. Gen. Stat. 20-102ee(a)). The Public Health Code carries the same 75/25 structure and adds that the elements are 'presented in both lecture and clinical settings' (19-13-D8t(l)(1)(A)). A third, newer component sits inside the 100: 'On and after January 1, 2022, not less than two of such hours shall include (1) screening for post-traumatic stress disorder, risk of suicide, depression and grief, and (2) suicide prevention training offered or approved by the American Nurses Association, Connecticut Hospital Association, Connecticut Nurses Association or Connecticut League for Nursing, a specialty nursing society or equivalent organization in another jurisdiction, a hospital or other health care institution, a regionally accredited academic institution, or a state or local health department' (20-102ee(a), added by P.A. 21-46 effective July 1, 2021). DPH states the total to program operators in one line: 'The total hours must equal a minimum of 100 hours including both clinical and classroom. The program can exceed the 100-hour minimum requirement.' No classroom/clinical hour split is published — the 75/25 division is by content, not by setting, and none of the Connecticut sources we checked states a minimum number of clinical hours. Connecticut therefore sits 25 hours above the federal 75-hour floor. Caution on the code text: the copy of 19-13-D8t(l) the Department publishes is stamped 'Current with materials published in Connecticut Law Journal through 4/9/02' and does not contain the two-hour post-traumatic stress and suicide-prevention component the legislature added in 2021; where the two disagree, the statute is the later enactment and this page follows it.",
   "lapse_rule": "What ends registry status is twenty-four months without paid nursing work, and the Public Health Code states the trigger directly: 'If, since an individual's most recent completion of a training and competency evaluation program, there has been a continuous period of twenty-four (24) consecutive months during none of which the individual performed nursing or nursing-related services for monetary compensation, such individual shall complete a new training and competency evaluation program, or a new competency evaluation program' (19-13-D8t(l)(3)). DPH translates that into two very different outcomes depending on why the certificate lapsed. If the aide worked but never filed the paperwork, the fix is paperwork: 'If your nurse aide certification has expired and you have been working as a CNA or in a position where you have provided nursing related services, but you did not submit verification of employment, you may submit an employment verification form verifying employment that started prior to the expiration of the certificate', and DPH adds elsewhere that an aide 'may submit an employment verification form for each two-year cycle since expiration.' Renewal is then effective two years from the last verified employment date, with no fee. If the aide did not work, the fix is the exam: 'If your nurse aide certification has expired/lapsed and you have not worked as a nurse aide or in a position where you provided nursing related services in a period longer than 24 months (2 years), you are required to retake and pass the Connecticut Nurse's Aide exam (written and practical examinations) administered by Prometric.' That is DPH's Route 4, and 'Subsequent to passing the examinations, registration will be renewed for two (2) years.' A name is never removed from the registry: 'Once a nurse's aide's name is on the registry it is never removed. The nurse's aide will be identified as active or lapsed.' Negative findings are a different and harsher thing: the registry 'will also identify whether there has been a negative finding against their certificate for resident abuse, resident neglect and/or misappropriation of resident property (stealing)', and 'A finding of resident abuse or misappropriation of resident property can never be removed from the registry.' Only neglect can be petitioned away, and only on conditions set by statute: the Commissioner must determine that '(1) The employment and personal history of the nurse's aide does not reflect a pattern of abusive behavior or neglect; and (2) the neglect involved in the original finding was a singular occurrence', and 'In no case shall a determination on a petition submitted under this subsection be made prior to the expiration of a one-year period beginning on the date on which the finding was added to the registry' (Conn. Gen. Stat. 20-102cc(b)). A complaint carries process rights: written notice by certified mail, and a request for a hearing filed 'not later than thirty days after the date of the mailing' (20-102cc(a)).",
   "reciprocity": "Connecticut calls it Route 7 and runs it without an exam. DPH: 'You would select this route (Route 7) if you have a current certificate/license in another state or U.S. territory. The credential must be active and in good standing.' The candidate handbook states the same test — 'Select this route if you are currently active and in good standing on a Registry in another state' — and confirms 'you are not required to take the exam. To be placed directly on the Registry, complete the Connecticut Nurse Aide Registry Application and send it to Prometric.' The fee on the current application is $55. The application asks the candidate to list every other state where they hold a nurse aide certification or registry listing and to state whether they are in good standing in each, defining the term: 'Good standing means that you have no findings or convictions of resident abuse, neglect or misappropriation of resident belongings.' The Public Health Code sets the underlying standard the Department applies: 'A nurse's aide registered in another state or territory of the United States may be entered on the registry, provided the department is satisfied that such nurse's aide has completed a training and competency evaluation program equal to or better than that required for registration in this state as of the date the nurse's aide was first registered in another state or territory' (19-13-D8t(l)(7)). Moving the other way — again Prometric's candidate handbook, not a DPH page: 'If you are active and in good standing on the CT CNA Registry and wish to apply to another state for reciprocity, you must contact the state you are moving to. Please note that the application will need to be sent to CT in order to obtain verification of certification.' Not the same thing as reciprocity: a nurse aide trained but never tested in another state within the past 24 months uses Route 3 and must sit the Connecticut exam.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Connecticut DPH — Nurse Aide Registration (the program's home page). Establishes the structure of the whole program: the links to the six eligibility routes, renewal and reinstatement, negative findings, training program requirements and the approved-program list; the pointer to the online registry search; the split of responsibilities between DPH ('For questions regarding nurse aide certificate renewals, contact the Connecticut Nurse's Aide Registry at (860) 509-7603 Press Option #1, dph.nurseaide@ct.gov') and Prometric ('For questions regarding nurse aide applications or failure to receive a new nurse aide certificate, contact Prometric'); and the separate Medication Administration Certificate pointer to Facility Licensing at 860-509-7400.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/nurse-aide-registration\"}, {\"label\": \"Connecticut DPH — New CNA - Route 1. Establishes the standard pathway ('successful completion of a Connecticut Department of Public Health (DPH) approved nurse's aide training program and passing the CT nurse's aide exam'), the requirement to pass 'both the written and practical parts of the Connecticut CNA examination administered by Prometric', the $118 examination fee as DPH states it, and the testing window: 'Nurse's aide candidates have 24 months from when they complete training to pass the CT nurse's aide examination. There are no limits as to how many times a candidate can take the examination within the 24 month period.'\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/route-1---new-cna\"}, {\"label\": \"Connecticut DPH — Student Nurse or Licensed Nurse - Route 2. Establishes the nursing-program pathway: 'at least 100 hours of theory and clinical instruction in an approved practical nurse or registered nurse program within 24 months of the date of application or be currently licensed as a RN or LPN in any of the 50 states or US territories', with both exam parts still required, and repeats the $118 figure.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/route-2-nurseor-student-nurse\"}, {\"label\": \"Connecticut DPH — Out-of-State Training - Route 3. Establishes the out-of-state training pathway: 'a state approved nurse's aide training program in another state within the past 24 months that consisted of a minimum of 100 hours of classroom and clinical instruction, but have not successfully completed that state's nurse's aide examination', with the Connecticut competency exam required.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/route-3-out-of-state-training\"}, {\"label\": \"Connecticut DPH — Reinstatement of a Lapsed Certification - Route 4. Establishes the route for a former Connecticut aide 'not eligible for renewal', who 'must take and pass the Connecticut nurse's aide competency exam.'\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/route-4-reinstatement-of-a-lapsed-certification\"}, {\"label\": \"Connecticut DPH — Certified in Another U.S. State (Route 7). Establishes the reciprocity test: 'if you have a current certificate/license in another state or U.S. territory. The credential must be active and in good standing', filed online or on a printable application sent to Prometric.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/certified-in-another-state-route-7\"}, {\"label\": \"Connecticut DPH — Nurse Aide Registration Renewal Requirements. Establishes the renewal rule ('nurse aides must have worked at least one 8-hour shift of paid employment as a nurse aide or in a position providing nursing related services prior to their nurse aide certificate expiring'), 'Renewals will be effective two years from the last date of reported/verified employment', 'There is no fee for renewal', the fax/email/mail filing channels, the multiple-aide facility form, and both expired-certificate outcomes — refile verification if the work happened, retake both exams if it did not.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/nurse-aide-registration-recertification-requirements\"}, {\"label\": \"Connecticut DPH — Recertification (the certification-and-renewal page). Restates the one eight-hour shift rule and the no-fee renewal, and adds that an aide who worked but never filed 'may submit an employment verification form for each two-year cycle since expiration', and that after re-passing the exam 'registration will be renewed for two (2) years.'\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/certification-and-renewal\"}, {\"label\": \"Connecticut DPH — Negative Findings. Establishes that 'Once a nurse's aide's name is on the registry it is never removed. The nurse's aide will be identified as active or lapsed', that a finding of resident abuse or misappropriation 'can never be removed from the registry', the neglect petition conditions, and that a flagged certificate 'will not be renewed and you are prohibited from working in a licensed chronic convalescent nursing home.'\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/negative-findings\"}, {\"label\": \"Connecticut DPH — Training Programs (nurse's aide training program requirements). Establishes that Public Health Code 19-13-D8t(l)(1)(A) requires DPH approval of all Connecticut nurse aide training programs, that approval runs two years subject to on-site observation, the list of changes programs must report, and the Office of Higher Education / Private Occupational School caveat for programs that charge.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/nurseaide/training-program-requirements\"}, {\"label\": \"Connecticut DPH — CT CNA Training Program Requirements (the document DPH hands prospective program operators). Establishes the hours rule in the Department's own words — 'The total hours must equal a minimum of 100 hours including both clinical and classroom. The program can exceed the 100-hour minimum requirement' — plus the required curriculum document, syllabus, primary training instructor and instructor resumes, clinical site agreement, sample completion certificate, and the on-site inspection checklist (classroom, skills lab, training equipment, hour-recording system, student files).\", \"url\": \"https://portal.ct.gov/dph/-/media/departments-and-agencies/dph/dph/practitioner_licensing_and_investigations/plis/nurse_aides/ct-cna-training-program-requirements.pdf\"}, {\"label\": \"Connecticut DPH — Nurse Aide Employment Verification Form (the renewal form). Establishes the form's own fields — certificate/registration number, date of hire, 'Last Reported Date of Employment', the Facility/Agency, Private Duty and Out of State check boxes, the duties description required of private-duty and physician's-office aides, and the employer representative's signed certification — and the filing address, fax (860) 707-1983 and email dph.nurseaide@ct.gov.\", \"url\": \"https://portal.ct.gov/dph/-/media/departments-and-agencies/dph/dph/practitioner_licensing_and_investigations/plis/nurse_aides/na-employment-verification-form.pdf\"}, {\"label\": \"Connecticut DPH — License Types with Continuing Education Requirements. The Department's own list of the 33 professions that 'require continuing education for license/certification renewal.' Nurse aide does not appear on it; the list is the sourced basis for the no-continuing-education finding on this page.\", \"url\": \"https://portal.ct.gov/dph/practitioner-licensing--investigations/plis/license-types-with-continuing-education-requirements\"}, {\"label\": \"Connecticut General Statutes, chapter 378a (Nurse's Aides), Connecticut General Assembly. Establishes the definitions in 20-102aa, the registry duty in 20-102bb, the complaint, finding and neglect-petition provisions in 20-102cc, the denial ground in 20-102dd, the 100-hour training mandate with the 75/25 split and the two-hour post-traumatic stress and suicide-prevention component in 20-102ee, and the licensure limit in 20-102ff. Carries the note that 'Readers should refer to the 2026 Supplement, revised to January 1, 2026, for updated versions of statutes amended, repealed or added during the 2025 legislative sessions.'\", \"url\": \"https://www.cga.ct.gov/current/pub/chap_378a.htm\"}, {\"label\": \"Connecticut Public Health Code 19-13-D8t — Chronic and convalescent nursing homes and rest homes with nursing supervision, subsection (l) Nurse's Aide Training and Employment, as published by the Department of Public Health. Establishes the 120-day employment bar, the training and competency evaluation program contents, instructor qualifications, the restricted-duty and staffing rules for untrained and untested workers, the registry data fields, the 24-consecutive-month lapse rule, the deemed-completion provisions, out-of-state registry entry, and the single 120-day period for out-of-state and CGFNS-certified nurses. Stamped 'Current with materials published in Connecticut Law Journal through 4/9/02.'\", \"url\": \"https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/facility_licensing_and_investigations/Nurse_Aide_Training/CNARegulationspdf.pdf\"}, {\"label\": \"Connecticut Nurse Aide exam page (Prometric, the contractor DPH names and links). The page DPH's route pages point candidates to for the application, the printable forms, the test site list, the clinical skills checklist and instructions, the employment verification forms and the registry link.\", \"url\": \"https://www.prometric.com/exams/nurseaide-ct\"}, {\"label\": \"Candidate Information Bulletin — State of Connecticut Certified Nurse Aide Examination (Prometric, revised 08212019, published on the Connecticut nurse aide exam page). Establishes the contract scope ('contracted with Prometric Inc. (Prometric) to develop and administer its Nurse Aide Competency Exam and to manage the Certified Nurse Aide (CNA) Registry'), the six eligibility routes and which of them skip the exam, the two-test structure and that neither test is a prerequisite for the other, the written test format ('60 multiple-choice questions... 90 minutes') and content outline weights, the oral form, the clinical skills structure ('scored on five skills... three assigned skills... Handwashing and Indirect Care', 31 to 40 minutes, 'you must pass all five skills'), the resident-actor skill list, test-site rules, the results and score-report process, the 60-day written appeals process, the renewal rule and the $15 duplicate certificate fee, and the older fee schedule including the $25 reschedule fee, $25 appeals/handscore fee and $20 processing fee.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/CT-CNA-CIB.pdf\"}, {\"label\": \"Connecticut Certified Nursing Assistant Examination Application (the current form on the Connecticut nurse aide exam page). Establishes the live fee schedule — first-time Written and Clinical Skills $125, Written (Spanish) and Clinical Skills (English) $125, Oral and Clinical Skills $125, Oral (Spanish) and Clinical Skills (English) $125; re-test Clinical Skills only $77, Written only $48, Written (Spanish) only $48, Oral only $48, Oral (Spanish) only $48; Route 5 $55; Route 7 $55; 'Rescheduling/No Show $20' — plus the route check boxes, the training instructor's certification line, the in-facility versus regional test site choice, the good-standing declaration for other states, the ADA accommodation box with its 30-day notice, and the payment rules ('Fees are non-refundable and non-transferrable', no personal checks or cash).\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/CT-CNA-Application.pdf\"}, {\"label\": \"Connecticut State Nurse Aide Registry public lookup (Prometric, the address DPH links from four of its nurse aide pages). Establishes the search fields, the employer-code option and the notice that 'The Dept of Health requires that all employers search the registry prior to employing a Nurse Aide.'\", \"url\": \"https://registry.prometric.com/registry/publicCT\"}]",
   "page_url": "https://licensingatlas.com/cna/ct-cna/"
  },
  {
   "page_id": "dc-cna",
   "state": "District of Columbia",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "District of Columbia Board of Nursing — 'a division within the DC Department of Health, Health Systems & Preparedness Administration (HSPA)', which the Board's own page says is 'responsible for the licensure and regulation of ... Nursing Assistive Personnel (NAPs) (i.e., dialysis techs (DTs), certified nursing assistants (CNAs), and home health aides (HHAs))' as well as APRNs, RNs and LPNs. Testing and the nurse aide registry are run for the Board by Credentia; the Board's own online licensing system is separate.",
   "board_url": "https://dchealth.dc.gov/service/board-nursing",
   "application_url": "https://dchealth.dc.gov/service/board-nursing",
   "renewal_cycle": "⚠ Two official answers coexist, and the rule itself authorises the second. The rule says October 31 of odd years: '[A] certification issued pursuant to this chapter shall expire at 11:59 p.m. on October 31 of each odd-numbered year' (17 DCMR § 9602.1). The very next subsection lets the director change that: 'The Director may modify the renewal system pursuant to § 4006.3 of Chapter 40 of this title and may modify the date on which a certification expires' (§ 9602.2). The director has done so. DC Health, citing that authority: 'DC Health is transitioning all professional licenses, certificates, and registrations to a birth-month renewal cycle. All credentials issued on or after June 16, 2024, will expire on the last day of the holder's birth month. This will also apply to renewing licensees beginning September 2024. Your new expiration date will always fall on the last day of your birth month. If your birthday is in an odd year, your future renewals will occur in odd years (and the same for even years). Applies to all new and renewal applicants.' So a CNA's actual expiry date now depends on when the certification was issued or last renewed, and the rule text has not been amended to match. Check your own record rather than assuming either date. ⚠ A dated Board notice sits above all of this and carries a hard work cutoff. On the Board of Nursing's own page, as published on August 16, 2026, a block headed 'RENEWAL NOTICE' states that renewals are running behind — 'due to the large number of licensees seeking renewal and the need to complete the required review (of criminal background check, etc.), the issuance of the renewed license is taking longer than expected' — and sets out what that means for the holder: 'Licensees who submit the renewal application before the expiration date of the license/certification/registration (June 30, 2026) are permitted to continue to work while their application is pending'; 'when the renewal applications are approved, the licenses will be renewed and active as of July 1, 2026'; 'For individuals who have applied for their renewal prior to the June 30, 2026, deadline, their status will be “Renewal Pending/ Authorized to Work”. For those who apply after the deadline, their status will be “Expired - renewal eligible”'; and the operative sentence, 'Licensees may not work beyond September 1, 2026, without an active license.' What the notice does not say is which credentials it reaches, and this page does not resolve that. It is published under the Board of Nursing heading and uses the District's standard three-part formula 'license/certification/registration' — and a DC CNA holds a certification under 17 DCMR ch. 96 — which reads inclusively; but the single June 30, 2026 expiry it names is a fixed date rather than the birth-month date the transition above puts on a CNA credential. The Board does not reconcile the two on the page. The notice's September 1, 2026 cutoff has now passed. The notice states it without qualification and does not say how a renewal still pending after that date is treated, so anyone in that position should check their own record with the Board. What renewal requires — 17 DCMR § 9607.1, three conditions: '(a) Having performed at least eight (8) hours of functions enumerated in § 9615.1 for compensation during the prior twenty-four (24) months; (b) Having completed, during the two (2) years before the expiration of the certification, twenty-four (24) hours of in-service training or continuing education relevant to the functions of nurse aides' including the two mandatory components described under continuing education; and '(c) Having received criminal background check clearance in accordance with § 9603.' How it is filed: through Credentia — create or log into the account, submit the renewal application for review, and upload the Certified Nurse Aide Employment Attestation Form, on which the supervising nurse confirms 'that this Certified Nurse Aide has provided a minimum of eight (8) hours of patient care within the past two years and the person is competent to provide the skills enumerated in 17 DCMR § 9615.1.' The form warns that 'Knowingly making a false statement on this form is a violation of D.C. Official Code § 22-2405(b) and may lead to criminal penalties.' A shortened term buys a continuing-education discount but not a fee discount: because the birth-month transition gave some holders less than a full two-year term, 'All Boards have approved acceptance of 50% of the Continuing Education (CE) requirements for licensees who have received less than two (2) years on their license term during this transition period... License holders are still responsible for the two (2) LGBTQ Cultural Competency and the 10% Public Health Priorities', while 'no fees will be discounted or prorated.' The Board is also required by statute to send a renewal notice at least 30 days before expiry stating the expiration date, the deadline and the renewal fee (D.C. Official Code § 3-1205.10(c)). Inactive status is available: 'A CNA with an active certification may request to be placed on inactive status', and 'While on inactive status, the individual shall not be subject to the renewal fee and shall not practice, attempt to practice, or offer to practice as a CNA' (§ 9608.1-.2).",
   "ce_hours": "24 hours every two years, with two mandatory components inside it. 17 DCMR § 9607.1(b) requires, during the two years before the certification expires, 'twenty-four (24) hours of in-service training or continuing education relevant to the functions of nurse aides', of which: '(i) Two (2) hours shall be in cultural competency or specialized clinical training focusing on patients or clients who identify as lesbian, gay, bisexual, transgender and queer in accordance with D.C. Official Code § 3-1205.10(b)(5); and (ii) Ten percent (10%) of the total shall be in subjects determined by the Director as public health priorities of the District, which shall be duly published every five (5) years or as deemed necessary.' Ten percent of 24 hours is 2.4 hours. The District's candidate handbook states the same requirement as an annual rhythm — '12 hours per year, totaling 24 hours over the two-year certification period', with training that 'must be related to the health or nursing needs of your client population' — and repeats both mandatory components. In-service counts, and the rule says whose it is: 'In-service - activities provided by the employer intended to assist the CNA in acquiring, maintaining, or increasing competence in fulfilling the assigned responsibilities specific to the expectations of the employer' (§ 9699.1). Hours can be shared across District credentials: 'Applicants who have another active District of Columbia certification as a nursing assistive personnel may apply continuing education hours to Nursing Assistive Personnel renewal requirements' (§ 9607.2). The Board audits and can adjust: 'The Board may conduct a random audit of renewal applicants or certified Nurse Aides to determine compliance' (§ 9607.3), and it 'shall have the authority to modify the number of hours... for good cause or if an extraordinary circumstance necessitates such modification' (§ 9607.4) — which is the authority under which the 50% transition allowance was granted. Not listed in the CNA rule: an HIV/AIDS component. The Health Occupations Revision Act directs the Mayor to require '3 credits of instruction on the Human Immunodeficiency Virus (\"HIV\") and the Auto Immune Deficiency Syndrome (\"AIDS\")' in the continuing education for several practices including 'The practice by nursing assistive personnel' (D.C. Official Code § 3-1205.10(b)(4)(A)(iv)), but the same section lets the Mayor waive that requirement by rule for one or more of those practices (§ 3-1205.10(b-1)(3)), and 17 DCMR § 9607.1(b) names only the LGBTQ and public-health components. This page therefore states the rule's two components and does not assert an HIV/AIDS requirement for CNAs.",
   "exam": "Two parts — a knowledge examination and a skill evaluation — and both must be passed within two years. The District's candidate handbook states the window and the attempt limit together: 'You must pass both parts of the examination within a two (2) year time period to be a part of the DC Nurse Aide Registry. Candidates are permitted three (3) attempts to pass the exam. After a third failure, you must complete another Nurse Aide training program and submit another application for examination.' ⚠ The same handbook states the third-failure consequence twice, and the two versions differ. The passage above is from 'Eligibility for NNAAP® Testing' on printed page 9. Fifty-seven pages later, under 'Exam Results' and the heading 'Failing Score' on printed page 66, the same document says: 'If you fail either part of the NNAAP® Examination three (3) times, you will need to complete either a remedial course or new program depending on your program completion date, and retake only the examination you failed', with a further bullet running onto page 67: 'In addition, if you were scheduled to take the exam 3 times and did not become licensed — either as a result of failing the exam or absence(s) — you will need to retrain.' The two diverge on both halves of what a candidate must do: 'another Nurse Aide training program' against 'either a remedial course or new program depending on your program completion date', and 'submit another application for examination' against 'retake only the examination you failed'. Both passages are printed in the District's current candidate handbook and neither is marked as superseding the other, so this page states both and attributes each rather than picking one. The time limit is stated two ways too: the eligibility section's 'two (2) year time period', and, under 'Eligibility Route Rules' in the results section, 'You must pass the exam within twelve (12) months from the application approval date.' The handbook's own first bullet in that same list is the practical pointer: 'If you fail the Written (or Oral) Examination or the Skills Evaluation, your Score Report will tell you how to retake either or both parts.' Written examination: 'The Written Examination has seventy (70) multiple-choice questions. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes are left to finish. Select only one (1) answer for each question.' Oral examination, offered in English and in Spanish, is a different instrument rather than a read-aloud of the same one: 'The Oral Examination consists of sixty (60) multiple-choice questions and ten (10) reading comprehension questions. Each of the sixty (60) multiple-choice questions will be repeated two (2) times, after which you mark your answer on an answer sheet. The reading comprehension questions test your knowledge of and familiarity with common, job-related words. Each of these words is repeated three (3) times. You have two (2) hours to complete the entire Oral Examination. You must pass both the multiple-choice and reading comprehension sections to pass the Oral Examination.' A self-assessment reading test in the handbook 'will help you decide if you should take the Oral Examination.' Skill evaluation: a separately priced, separately scheduled in-person component, and there is a hard medical bar on taking it early — 'Candidates are prohibited from taking the Skills Evaluation if on limited activity or light duty due to medical reasons... Candidates on light duty cannot take the Skills Evaluation; however, they can take the written/oral exam. Medical documentation stating return to full duty is required to take the skills evaluation.' The District publishes its own Nurse Aide Clinical Evaluation and Nurse Aide Skills documents alongside the curriculum. The District does not publish a passing score, and this page states none.",
   "fees": "Examination fees are published; the certification fee is not. The exam side, from the District's candidate handbook: Skill Evaluation only $110; Written Examination $55; Oral Examination only (Spanish) $55; Oral Examination only (English) $55. 'Fees are not refundable. If you do not bring proper identification, you will not be allowed to test, and your examination fee will not be refunded.' Payment must be 'in the form of a credit card, debit card, single use card or electronic voucher. Vouchers can be purchased by the training programs.' Many candidates do not pay these at all: 'Under federal and District of Columbia laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test.' Renewal costs nothing to file: the handbook's renewal instructions state 'No payment is required to submit your renewal application.' The one published District fee for a CNA is the fast-track route: the Board's announcement of the 90-day temporary certification for Maryland and Virginia CNAs says to 'submit proof of certification, pay the $50 fee, and pass a background check.' A criminal background check payment is required through the DC Health CBC Payment Portal before fingerprinting; its amount is not stated in any CNA-facing source we checked, though the District's fee rule sets a $50 criminal background check charge for the licensed professions it does cover. No CNA line exists in the District's fee regulation, and that is something we searched for rather than overlooked: 17 DCMR § 3500, as last amended 17 May 2024, lists fee schedules for home health aide (initial certification $50, endorsement $50, renewal $50, reinstatement $70, inactive status $10, late renewal $20, certificate duplication $34, added authority $10), medication aide (identical figures), dialysis technician, patient care technician and trained medication employees — and contains no entry for Certified Nurse Aide, Nurse Aide or Nursing Assistant. Not a District fee: training program tuition.",
   "legal_basis": "[{\"citation\": \"17 DCMR ch. 96 (Certified Nurse Aides), §§ 9600 through 9699\", \"what_it_governs\": \"The entire District CNA scheme: general provisions and the home-setting authority (9600); the four-month certification deadline (9601); the term of certification (9602); the criminal background check (9603); the general requirements including the age-18 minimum (9604); certification by examination and the three eligibility routes (9605); certification by endorsement (9606); renewal, its eight-hour work condition and its 24-hour education condition (9607); inactive status and reactivation (9608); reinstatement and the five-year line (9609); assignment and delegation (9613); the authorized task list (9615); discipline (9617); action on complaints of abuse, neglect and misappropriation (9618); training program standards, approval, review and requirements (9620 through 9632); the nurse aide registry (9651); and the definitions (9699).\", \"url\": \"https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?ChapterNum=17-96\"}, {\"citation\": \"17 DCMR § 9600 (General Provisions), as amended by Final Rulemaking published at 71 DCR 010370, effective 16 August 2024\", \"what_it_governs\": \"That the chapter applies to applicants for and holders of CNA certification and supersedes 29 DCMR ch. 32; the transitional protection for people certified under the predecessor rules; the requirement that all CNAs be registered under § 9651; the closed practice and reserved title at § 9600.4; and the 2024 addition at § 9600.5 permitting a CNA to provide nursing care services in a home setting on stated conditions. The amending notice is headed 'Health, Department of - Notice of Final Rulemaking - Amending 17 DCMR Ch. 96 - To Permit the Use of Certified Nurse Aides (CNA) in a Home Setting'.\", \"url\": \"https://www.dcregs.dc.gov/Common/NoticeDetail.aspx?NoticeId=N137283\"}, {\"citation\": \"17 DCMR § 3500 (Fees), as last amended by Final Rulemaking published at 71 DCR 006173 (17 May 2024)\", \"what_it_governs\": \"The District's health-occupation fee schedule, profession by profession. Cited here for what it does not contain: it sets initial certification, endorsement, renewal, reinstatement, inactive-status, late-renewal, duplication and added-authority fees for the Home Health Aide, the Medication Aide, the Dialysis Technician, the Patient Care Technician and the Trained Medication Employee, and a $50 criminal background check charge across the licensed professions, but has no entry for the Certified Nurse Aide.\", \"url\": \"https://www.dcregs.dc.gov/Common/DCMR/SectionList.aspx?SectionNumber=17-3500\"}, {\"citation\": \"D.C. Official Code § 3-1202.04 (Board of Nursing), part of the District of Columbia Health Occupations Revision Act of 1985 (D.C. Law 6-99), D.C. Official Code § 3-1201.01 et seq.\", \"what_it_governs\": \"The establishment and composition of the Board of Nursing and its authority over the practice of advanced practice registered nursing, registered nursing, practical nursing and nursing assistive personnel. The Board directs applicants to review this section before starting an application. The rulemaking authority for 17 DCMR ch. 96 is cited on the rule itself as § 302(14) of the Act, D.C. Official Code § 3-1203.02(14), together with Mayor's Order 98-140.\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/3-1202.04\"}, {\"citation\": \"D.C. Official Code § 3-1205.10 (Term and renewal of licenses, registrations, or certifications)\", \"what_it_governs\": \"The statutory ceiling on credential terms, quoted whole because the exception is load-bearing here: 'The term of a license, registration, or certification shall not exceed 2 years; except, that the Mayor may by rule provide for a period of licensure, registration, or certification of not more than 3 years' (§ 3-1205.10(a)) — and the Mayor has so provided, since 17 DCMR § 4006.4 permits extending a term already in effect 'up to three (3) years' to make the birth-month transition orderly; the same subsection adds that 'An expiring license, registration, or certification may be renewed in accordance with rules issued by the Mayor'; the Mayor's authority to set continuing education requirements by rule; the two-credit LGBTQ cultural competency mandate at subsection (b)(5) that 17 DCMR § 9607.1(b)(i) implements; the three-credit HIV/AIDS instruction directive at (b)(4)(A)(iv) covering 'The practice by nursing assistive personnel' and the Mayor's authority to waive it by rule at (b-1)(3); and the duty at subsection (c) to send a renewal notice at least 30 days before expiry stating the expiration date, the deadline and the renewal fee.\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/3-1205.10\"}, {\"citation\": \"17 DCMR § 4006 (Term of a License, Certificate, or Registration), Chapter 40, Health Occupations: General Rules — effective 25 March 2022\", \"what_it_governs\": \"The authority DC Health cites for changing when credentials expire, and the mechanism behind the shortened and lengthened terms the birth-month transition produced. 17 DCMR § 9602.2 provides that 'The Director may modify the renewal system pursuant to § 4006.3 of Chapter 40 of this title and may modify the date on which a certification expires', and § 4006 supplies the rest. § 4006.1: 'The term of a license, certificate, or registration issued or renewed pursuant to this subtitle shall be two (2) years or for the balance of the license period, whichever is shorter.' § 4006.2 makes expiry follow the date this subtitle sets for the particular health occupation 'unless the Director changes the renewal system pursuant to § 4006.3 or extends the term pursuant to § 4006.5.' § 4006.3, the provision itself: 'The Director may change the renewal system whereby the license, certificate, or registration expires on the last day of the month of the birthdate of the applicant for or holder of the license, certificate, or registration.' § 4006.4: 'If the Director changes the renewal system under § 4006.3, in order to permit an orderly transition, the term of a license, certificate, or registration that is in effect on the date of the Director's determination may be extended up to three (3) years.' § 4006.5 separately lets the Director extend a term 'for administrative convenience, or if the Director determines that there is an exigent circumstance that requires an extension for the preservation of the health and safety of the public', and § 4006.6 requires a notice of any such extension 'which shall not exceed ninety (90) days'. Amendment history on the section: 34 DCR 5859, 5864 (September 11, 1987); 54 DCR 8930 (September 14, 2007); 69 DCR 002467 (March 25, 2022).\", \"url\": \"https://www.dcregs.dc.gov/Common/DCMR/SectionList.aspx?SectionNumber=17-4006\"}]",
   "exam_vendor": "Credentia, delivering the National Nurse Aide Assessment Program (NNAAP) for the District. The Board of Nursing routes candidates to it by name — 'Sign up for Testing- Nurse Aide Testing in DC | Credentia' and 'Potential candidates will still need to apply for testing with Credentia' — publishes the vendor's District candidate handbook on its own site as the guide to use, and gives the vendor's support line for skills-exam problems. The rule names the examination rather than the company: 'Receive a passing score on the National Council of State Boards of Nursing, Inc. (NCSBN) National Nurse Aide Assessment Program (NNAAP) or another national examination approved by the Board' (17 DCMR § 9605.1(a)), and § 9604.1(c) allows either 'A Board-approved nurse aide assessment program' or another program 'recognized by the Centers for Medicare and Medicaid Services (CMS) and the Board.' The platform changed, and old accounts do not carry over: 'If you previously had an online Pearson VUE account to register for examinations and/or manage your nurse aide registration, you'll need to create a new Credentia Platform online account', though 'all of the data from your old Pearson VUE online account will carry over to your new Credentia account.' Online proctoring is offered for the written and oral examinations, with 'A live proctor... through the webcam on your workstation.' The vendor is named because the District names it. One condition on this page comes from the vendor's own District page and is attributed to it wherever it appears: the continued-enrolment work rule (one documented eight-hour paid day in 24 months).",
   "training_hours": "125 hours total — 65 classroom, 20 lab and 40 clinical — one of the highest state minimums in the country, and well above the federal floor of 75. The figure is published on the Board of Nursing's own Nurse Aide Curriculum, whose running header on every page reads 'NA (65 classroom + 20 lab + 40 clinical = 125 hours total)', dated 11/2019. That curriculum is what the rule requires programs to use: 'Training programs shall use Board approved CNA model curriculum, that consists of classroom, skills laboratory, and supervised practice hours and may be amended from time to time' (17 DCMR § 9627.1). Note that the rule itself carries no hour figure — the number lives in the curriculum document the rule incorporates, which is why it is easy to miss. The three components are defined separately and one definition matters: 'Clinical - faculty planned and guided learning activities designed to assist in meeting course objectives and to apply nursing knowledge and skills in the direct care of clients, including clinical conferences and planned learning activities in acute care facilities, and other community resources. Clinical shall not include skills lab activities'; 'Skills laboratory - faculty guided activities planned for students in a school/campus laboratory that simulates the activities provided by the CNA' (§ 9699.1). So the 20 lab hours cannot be counted toward the 40 clinical hours. The curriculum allocates suggested hours unit by unit across content topics that include the role of the nurse aide, legal and ethical duties, 'Care sensitive to culture, religion, national origin, gender identity and sexual orientation' — which expressly covers 'the protections afforded LGBT people by the D.C. Human Rights Act' — communication, and basic safety skills. A separate 40-HOUR figure appears on the alternative route and should not be confused with the clinical component of a CNA course: an applicant may qualify to sit the examination through 'a practical nursing or registered nursing \"Fundamentals of Nursing\" course with a minimum forty (40) hours clinical component which includes skills as specified in § 9615' (§ 9605.2(b)).",
   "lapse_rule": "Five years to reinstate, then you start over. 17 DCMR § 9609.1: if a CNA fails to renew, the Board shall reinstate the certification if the applicant '(a) Applies to the Board for reinstatement of the certification within five (5) years after the certification expires; (b) Provides evidence of having completed twenty-four (24) hours of in-service training or continuing education within the past two (2) years prior to submission of an application; (c) Provides evidence of current CNA certification or registration; (d) Provides evidence of having worked for a minimum of eight (8) hours within the last twenty-four (24) months as a CNA; and (e) Completes a CBC as required in accordance with Title 17 DCMR Chapter 85.' Past that line the route is the examination again: 'If a CNA does meet the requirements specified in § 9609.1 and fails to apply for reinstatement within five (5) years after his or her certification expires, the applicant shall meet the requirements for certification pursuant to § 9605' (§ 9609.2). Reactivation from inactive status is a parallel, slightly different list: apply to the Board; show 24 hours of in-service or continuing education within the past two years; 'Provide evidence of current CNA certification or registration in another jurisdiction'; and show at least eight hours of nursing services worked within the past two years (§ 9608.3). Registry enrolment has its own continuing condition, stated by the District's registry operator: 'To be eligible for continued enrollment on the District of Columbia Nurse Aide Registry, you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay during the previous twenty-four (24) months, under the supervision of an RN or LPN.' A separate 24-MONTH rule applies before you ever certify: an applicant who becomes eligible to test and then lets more than 24 months pass without taking or passing the examination must satisfy § 9605.1(a) afresh (§ 9605.4); and the testing side allows three attempts, after which the District's candidate handbook gives two different consequences in two different places: 'you must complete another Nurse Aide training program and submit another application for examination' (printed page 9) against 'you will need to complete either a remedial course or new program depending on your program completion date, and retake only the examination you failed' (printed page 66). Both are in the current handbook; the full text of each is quoted under exam. A finding of abuse, neglect or misappropriation is not a lapse but a public bar: DC Health publishes a CNA Abuse Registry naming individuals with certification numbers, effective dates and, in many entries, the Superior Court case number and conviction. 17 DCMR § 9618 governs action on such complaints.",
   "reciprocity": "Certification by endorsement, plus a fast lane for the two neighbouring states. The ordinary route — 17 DCMR § 9606: 'An applicant currently working in another jurisdiction as a CNA shall apply for CNA by endorsement in order to work in the District of Columbia as a CNA', and shall provide proof of '(a) Current unencumbered registration or certification as a CNA in another jurisdiction; and (b) Meeting the requirements of § 9604' — which brings back the age-18, background-check, examination-evidence and completed-application requirements. The rule defines what endorsement is testing for: 'Endorsement - the process of issuing a certification to an applicant who is registered by a state Board and recognized by the Board as a qualified professional according to standards that were the substantial equivalent at the time of the certification to the standards for that profession set forth in this chapter and who has continually remained in good standing with the Board from the date of certification until the date of certification in the District' (§ 9699.1). The Maryland and Virginia fast track, announced by the Board: 'The District's Board of Nursing now offers a temporary 90-day certification for Certified Nurse Aides (CNAs) who are already in good standing from Maryland or Virginia. To apply, submit proof of certification, pay the $50 fee, and pass a background check. Complete applications are reviewed within 5 business days. As credentials are being verified, CNAs can work under the temporary certification. Once approved, CNAs will receive full District certification by endorsement.' That is a genuine bridge: it lets a Maryland or Virginia CNA start work while the full endorsement is verified, rather than waiting. Where it is filed: initial, endorsement and reciprocity applications go through the Board's own online licensing system, while the registry side is handled by Credentia — 'If you are a nurse aide currently listed on another state's nurse aide (or equivalent) registry as active and in good standing and wish to enroll on the District of Columbia Nurse Aide Registry', you create a Credentia Platform account and submit a reciprocity application. There is no published list of pre-approved states beyond the Maryland and Virginia fast track; the general test is the substantial-equivalence definition above, applied by the Board.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"District of Columbia Board of Nursing (DC Health). The core page. Establishes the Board's composition and remit including 'Nursing Assistive Personnel (NAPs) (i.e., dialysis techs (DTs), certified nursing assistants (CNAs), and home health aides (HHAs))'; the birth-month renewal transition effective 16 June 2024 and its 50% continuing-education allowance with the LGBTQ and public-health components preserved; the announcement that 'the Certified Nurse Aide (CNA) application is now live in Salesforce'; the Maryland and Virginia 90-day fast-track certification with its $50 fee and five-business-day review; the CNA application, testing, renewal, status and reinstatement routes and which system each uses; the criminal background check instructions and the Fieldprint correspondence warning; the renewal notice stating that timely applicants may keep working with status 'Renewal Pending/ Authorized to Work' and that 'Licensees may not work beyond September 1, 2026, without an active license'; and the staff contact list showing which specialists handle CNA matters.\", \"url\": \"https://dchealth.dc.gov/service/board-nursing\"}, {\"label\": \"17 DCMR ch. 96 (Certified Nurse Aides) — chapter section list, DC Office of Documents and Administrative Issuances. Establishes the chapter's structure and the effective date of each section: 9600 General Provisions (8/16/2024), 9601 Nurse Aide Certification (8/20/2021), 9602 Term of Certification (8/23/2019), 9603 Criminal Background Check, 9604 General Requirements, 9605 Requirements for Certification by Examination (8/20/2021), 9606 Endorsement, 9607 Renewal (8/20/2021), 9608 Inactive Status and Reactivation, 9609 Reinstatement, 9613 Assignment and Delegation, 9615 Certified Nursing Assistant Tasks, 9617 Discipline, 9618 Action on Complaints of Resident Neglect and Abuse, 9620 Standards for Training Programs, 9621 Supervised Practice of Trainees, 9624 Training Program Approval Procedures, 9625 Periodic Review, 9627 Training Program Requirements, 9628 Minimum Qualifications for Trainees, 9630 Closing of Programs, 9631 Records Retention, 9632 Resources, 9651 Nurse Aide Registry (8/20/2021) and 9699 Definitions (8/20/2021).\", \"url\": \"https://www.dcregs.dc.gov/Common/DCMR/RuleList.aspx?ChapterNum=17-96\"}, {\"label\": \"17 DCMR § 9600 (General Provisions) — section record with authority, source and rulemaking history. Establishes the authority line (§ 302(14) of the Health Occupations Revision Act of 1985, D.C. Official Code § 3-1203.02(14), and Mayor's Order 98-140) and the source chain: 'Final Rulemaking published at 66 DCR 11404 (August 23, 2019); as amended by Final Rulemaking published at 68 DCR 8239 (August 20, 2021); as amended by Final Rulemaking published at 71 DCR 010370 (August 16, 2024).' The rule text establishes § 9600.1 through § 9600.5, including the reserved title and the home-setting conditions.\", \"url\": \"https://www.dcregs.dc.gov/Common/DCMR/SectionList.aspx?SectionNumber=17-9600\"}, {\"label\": \"DC Register notice N137283 — 'Health, Department of - Notice of Final Rulemaking - Amending 17 DCMR Ch. 96 - To Permit the Use of Certified Nurse Aides (CNA) in a Home Setting', published 16 August 2024 at 71 DCR 010370, Vol 71/33. Establishes the 2024 home-setting amendment to § 9600 and is the one DC Register notice with a stable, linkable address used on this page ('Link to this Notice' is published on the page itself).\", \"url\": \"https://www.dcregs.dc.gov/Common/NoticeDetail.aspx?NoticeId=N137283\"}, {\"label\": \"District of Columbia Board of Nursing — Nurse Aide Curriculum (11/2019), published by DC Health. Establishes the District's training-hour requirement in its running header on every page — 'NA (65 classroom + 20 lab + 40 clinical = 125 hours total)' — and the unit-by-unit content topics, objectives and suggested hours, including the units on the role of the nurse aide, legal and ethical duties covering OBRA and abuse reporting, care sensitive to culture, religion, national origin, gender identity and sexual orientation (with 'the protections afforded LGBT people by the D.C. Human Rights Act'), communication, and basic safety skills.\", \"url\": \"https://dchealth.dc.gov/sites/default/files/dc/sites/doh/service_content/attachments/Certified%20Nurse%20Aide%20Curriculum.pdf\"}, {\"label\": \"DC Health — Nursing Assistive Personnel Training Programs (CNA, HHA, TME). Establishes that the District publishes, for the CNA lane, the Nurse Aide Curriculum, the Nurse Aide Clinical Evaluation and the Nurse Aide Skills documents, the list of approved Nurse Aide Training Programs (2024), and NNAAP examination pass rates by year (2015 through 2022) — the published output of the 75% program pass-rate rule at 17 DCMR § 9627.3.\", \"url\": \"https://dchealth.dc.gov/node/1644966\"}, {\"label\": \"Candidate Handbook, District of Columbia – NNAAP, Credentia, dated 27 March 2026, published on DC Health's own site and linked by the Board of Nursing as the guide to use. Establishes the two-part examination and the rule that 'You must pass both parts of the examination within a two (2) year time period to be a part of the DC Nurse Aide Registry. Candidates are permitted three (3) attempts to pass the exam'; the eligibility routes D1, D2, D4 and D5; the light-duty bar on the Skills Evaluation; the examination fee table (Skill Evaluation only $110, Written Examination $55, Oral Examination Spanish $55, Oral Examination English $55) with 'Fees are not refundable' and the rule that 'nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test'; the written examination's 70 questions in two hours and the oral examination's 60 multiple-choice plus 10 reading-comprehension questions in two hours with both sections required to pass; and the renewal instructions including 'No payment is required to submit your renewal application', the Certified Nurse Aide Employment Attestation Form upload, '12 hours per year, totaling 24 hours over the two-year certification period', the 10% public-health and 2-hour LGBTQ+ components, the eight-hour work-experience proof, and the criminal background check payment portal and Fieldprint code sequence.\", \"url\": \"https://dchealth.dc.gov/sites/default/files/dc/sites/doh/service_content/attachments/Candidate_Handbook.pdf\"}, {\"label\": \"DC Health — Certified Nurse Aide Employment Attestation form (9/12/2023). Establishes the renewal attestation the supervising nurse signs: 'Pursuant to 17 DCMR § 9607.1(a), I, this applicant's supervising nurse, confirm that this Certified Nurse Aide has provided a minimum of eight (8) hours of patient care within the past two years and the person is competent to provide the skills enumerated in 17 DCMR § 9615.1', together with the false-statement warning citing D.C. Official Code § 22-2405(b).\", \"url\": \"https://dchealth.dc.gov/sites/default/files/dc/sites/doh/page_content/attachments/CNA%20Renewal%20Attestation%20sep%2012%202023.pdf\"}, {\"label\": \"DC Health — CNA Abuse Registry. Establishes that the District publishes the abuse registry as an ordinary readable web page, listing each individual's name, certification number (all beginning with the NA prefix), effective date and, for many entries, the Superior Court of the District of Columbia case number and the conviction — for example criminal neglect of a vulnerable adult, criminal abuse of a vulnerable adult, theft and misappropriation — or an Order of the Board.\", \"url\": \"https://dchealth.dc.gov/node/149282\"}, {\"label\": \"DC Health Board of Nursing — Regulatory Quick Reference Guide, April 2026 v3. Establishes the Board's own map of which regulation covers what: within Title 17 DCMR, 3500 Fees, 4000 Health Occupations, 5200 General Provisions, 5400 Registered Nurse, 5500 Licensed Practical Nurse, 6100 Trained Medication Employee, 8500 Criminal Background Check, 9300 Home Health Aide, 9400 Dialysis Technologist, 9500 Medication Aide-Certified, 9600 Certified Nurse Aide and 9700 Patient Care Technologist; and within Title 22 DCMR, B32 Nursing Facilities and B39 Home Care Agencies among others.\", \"url\": \"https://dchealth.dc.gov/sites/default/files/dc/sites/doh/BON%20Regulatory%20Quick%20Reference%20Guide%204.1.26.pdf\"}, {\"label\": \"Credentia — District of Columbia test-taker page (the testing and registry site the DC Board of Nursing links from its own Board page). Establishes that a student 'must complete the state-approved nurse aide training program' or register under another handbook eligibility route; the migration from Pearson VUE accounts to the Credentia Platform and that prior account data carries over; the availability of online proctored written and oral examinations; the registry search requirement — 'To conduct a search, you will need the name, city, and date of birth OR registration number of the nurse aide'; the continued-enrolment condition 'you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay during the previous twenty-four (24) months, under the supervision of an RN or LPN'; and the reciprocity route for nurse aides listed as active and in good standing on another state's registry.\", \"url\": \"https://credentia.com/test-takers/dc/\"}, {\"label\": \"D.C. Official Code § 3-1205.10 (Term and renewal of licenses, registrations, or certifications), Council of the District of Columbia. Establishes the credential-term ceiling in full — 'The term of a license, registration, or certification shall not exceed 2 years; except, that the Mayor may by rule provide for a period of licensure, registration, or certification of not more than 3 years' (§ 3-1205.10(a)), followed by 'An expiring license, registration, or certification may be renewed in accordance with rules issued by the Mayor'; the two-credit LGBTQ cultural competency continuing-education mandate at (b)(5) that the CNA rule implements; the three-credit HIV/AIDS directive at (b)(4)(A)(iv) reaching 'The practice by nursing assistive personnel' and the Mayor's waiver authority at (b-1)(3); and the 30-day renewal-notice duty at (c).\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/3-1205.10\"}, {\"label\": \"D.C. Official Code § 3-1202.04 (Board of Nursing), Council of the District of Columbia — the statutory establishment of the Board, which the Board itself tells applicants to review before starting an application.\", \"url\": \"https://code.dccouncil.gov/us/dc/council/code/sections/3-1202.04\"}, {\"label\": \"Credentia — District of Columbia Nurse Aide Registry search (the public lookup for registry enrolment). Cited for the search itself; its interface is built in the browser and returns no result address that can be linked.\", \"url\": \"https://cna365.examroom.ai/registry?StateCode=DC\"}]",
   "page_url": "https://licensingatlas.com/cna/dc-cna/"
  },
  {
   "page_id": "de-cna",
   "state": "Delaware",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Delaware Department of Health and Social Services (DHSS) — Division of Health Care Quality (DHCQ), CNA Registry and Office of Long Term Care Residents Protection",
   "board_url": "https://www.dhss.delaware.gov/dhss/dltcrp/cnareg.html",
   "application_url": "https://www.prometric.com/exams/nurseaide-de",
   "renewal_cycle": "Every two years, and it takes three things — an application with a $25.00 fee, 24 hours of approved continuing education, and 64 hours of paid work. All three are filed in one place: since January 1, 2020 the renewal form, the continuing education and the $25.00 payment are completed through the Relias site the Division names in its renewal notice, https://decnarecert.academy.reliaslearning.com, not by mailing anything to the Division — 'As of January 1, 2020, CNAs will no longer be sending their payments or renewal forms to the Division of Health Care Quality. Both the $25.00 renewal fee and renewal form will be completed through the RELIAS website.' The Division's renewal notice also states the turnaround and how the result is confirmed: 'Once you have completed all steps for recertification and your information is verified, your renewal will be processed; allow up to 48 hours for this process to be completed. Once completed, you will appear on the State of Delaware Registry as ‘ACTIVE’ for another two (2) years/(24 months). You may visit https://registry.prometric.com/publicDE to verify that your certificate is available as the state of Delaware does not provide certification cards.' The statute sets the cycle: 'Every certified nursing assistant shall recertify biennially by filing an application', and on receipt of the application and fee the Department 'shall... issue to the applicant a certificate of renewal for 2 years, provided that the applicant has successfully completed continuing education requirements as established by the Department' (16 Del. C. 3006A(a)-(b)). The regulation adds the deadline and the work test: 'CNAs must apply for certification renewal at least 30 days prior to the expiration date of the certification' (16 DE Admin. Code 3220, 2.3.2), and 'In order to qualify for recertification, a CNA must complete the following during each 24 month certification period and prior to certification expiration: 24 hours of Department approved continuing education which must include: Six (6) hours of dementia training and Two (2) hours of resident/patient abuse/neglect/mistreatment prevention training. Perform at least 64 hours of nursing related services for pay under the supervision of a nurse' (2.3.4). Orientation hours count toward the work half: 'Orientation may also be considered as part of the 64 hour work requirement for certification renewal' (4.1.2). Military deferral: the certification of a CNA 'on active military duty with the armed forces of the United States and serving in a theater of hostilities on the date that recertification is due shall be deemed to be current and in full compliance... until the expiration of 30 days after such CNA is no longer on active military duty in a theater of hostilities' (16 Del. C. 3006A(a); 3220, 2.3.7). A renewal cannot be bought without the work and the courses: 'A certification renewal will not be issued to a CNA who has not completed the requirements for renewal... and/or has not submitted an application for renewal and/or has not submitted the renewal fee' (2.3.3), and 'A CNA who fails to complete the requirements... must take and pass the competency test again' (2.3.5). A flagged registry record also blocks renewal: 'If your record in the Delaware NA Registry is flagged for resident abuse or neglect, misappropriation of resident property or Medicaid fraud, your certification will not be renewed.'",
   "ce_hours": "24 hours of Department-approved continuing education per two-year certification period, with two mandated subjects inside it: 'Six (6) hours of dementia training' and 'Two (2) hours of resident/patient abuse/neglect/mistreatment prevention training' (16 DE Admin. Code 3220, 2.3.4.1). The continuing education must be completed 'during each 24 month certification period and prior to certification expiration', and failing to do it is itself a disciplinary ground: 'Failing to comply with the requirements for mandatory continuing education' (3220, 5.1.13). Delaware closes the obvious loophole in terms: 'A CNA, who is certified in Delaware, may not use the certification from another State for the purpose of applying for reciprocity to avoid Delaware's continuing education requirements' (2.3.10). The statute ties the renewal fee to the education infrastructure — the fee 'shall approximate and reasonably reflect all costs necessary to defray the expenses of maintaining an educational website from which certified nursing assistants will receive the required educational credits' (16 Del. C. 3006A(b)(2)). Where the hours are taken and recorded: Relias. Every Delaware CNA has an account in it, and the Division of Health Care Quality says so on its own letterhead. Its Nurse Aide Certification Renewal notice (3/2023) reads: 'All State of Delaware CNAs have been registered in the Relias system. Sign in and complete your continuing education units by visiting https://decnarecert.academy.reliaslearning.com. Log in by entering your email address and the temporary password which is ‘WELCOME1’. (The password is case sensitive so be sure to type W in uppercase, the remaining letters in lowercase, and the numeral 1 with no spaces in between.) If your email address does not work as a login, you must use your CNA Certificate Number.' The same notice gives the help line: 'If you need assistance, please call the RELIAS Helpdesk at 1-844-735-2223. Once logged in, please update any demographic information (i.e., name, address, etc.) and upload any supporting documentation (i.e., copy of photo ID, marriage license, divorce decree, etc.) if there are changes.' The Division's notice of the changeover explains how Delaware got here and what the platform does: 'Currently, Delaware CNAs are required to take 24 hours of CEUs every two years through an online company named Elsevier. On January 1, 2020, the company that CNAs will be required to take online training from will be RELIAS'; 'CNAs must obtain an individual e-mail address to create an account in RELIAS'; 'CNAs will be taking their CEU classes that will be presented in a bundled package selected by DHCQ'; 'There will be an option in RELIAS to upload transcripts for college nursing classes to receive General CEU credits'; and 'RELIAS customer service operates Monday-Friday from 8:00 am to 8:00 pm.' The 64-hour work requirement is documented inside the same platform: 'CNAs will select the 64 hour Employment Verification Statement as a class and document their employment history. The DHCQ staff will verify this information. Falsifying information could result in a CNA’s certification being revoked.' One citation in the older candidate bulletin is out of date, not mysterious: the bulletin (revised 07/18/2018) tells CNAs their hours 'must be entered onto the new CE Site (www.cnadece.org) by an approved education provider'. That address no longer exists — it is the superseded vendor site, replaced by Relias on January 1, 2020, and the bulletin simply predates the change. Follow the Division's renewal notice, not the bulletin, on where the hours are taken and recorded.",
   "exam": "Two tests, both required: 'The Delaware Nurse Aide Competency Exam consists of two separate tests that evaluate your nurse aide knowledge and skills. One test is a hands-on skills demonstration referred to as the Clinical Skills Test. The other test is a Written Test. First-time testers must register for both tests.' Written test — 'The Written test consists of 60 multiple-choice questions. You will have 90 minutes to take the test', built on a published content outline weighted 18% Role of the Nurse Aide, 18% Promotion of Safety and 24% Promotion of Function and Health of Residents among its domains. Oral form — the written test may be taken orally instead, selected on the application. Clinical skills test — scored on five skills, three assigned plus Handwashing and Indirect Care, and 'You must pass all five skills to pass the Clinical Skills Test.' Candidates volunteer as the resident for another candidate, and the bulletin lists the twelve skills that may be performed on a resident actor; the evaluator 'can stop the testing of a skill if the resident actor/volunteer is in danger.' Attempts — three, and the regulation is the authority: 'Students who fail to obtain a passing score may repeat the test two additional times' and 'Students who fail to obtain a passing score after testing three times must repeat the CNA training program before retaking the test' (16 DE Admin. Code 3220, 2.1.5). The bulletin states the same limit with the deadline attached: 'You have three attempts to pass the Written and Clinical Skills tests within 24 months of completing your training program.' Only the failed test has to be repeated, and each attempt needs its own application and fee. Language — 'The Delaware Nurse Aide Competency Exam is offered only in English. Translators are not permitted and translation dictionaries may not be used during the exam administration'; the oral format is offered as the alternative and is not an ADA accommodation. Where — in-facility test sites scheduled by the nursing home or training program, or regional test sites in New Castle, Kent and Sussex counties, with the current list published by the contractor. Identification — two valid pieces, one a current government-issued photo identification, and the original admission letter must be presented. Results — the written test returns an on-screen pass/fail report; the clinical skills report is handed over at the test site shortly after the test; scores 'are confidential and will be revealed only to you and the state. Scores are not given out over the phone.' No numeric passing score is published in any Delaware source we checked. Accommodations — documentation of a disability recognized under the Americans with Disabilities Act is submitted with the application, thirty days' advance notice is required, and 'There is no additional charge for these accommodations.' Appeals — a signed written appeal must reach the contractor's appeals committee within 60 days of the test date; 'Faxed appeals will not be accepted because an original signature is required.'",
   "fees": "Exam fees, paid to the testing contractor with the application (from the Delaware Nurse Aide Exam Application and the candidate bulletin, which agree): Written Test and Clinical Skills Test $115; Oral Test and Clinical Skills Test $115; Clinical Skills Test retake only $75; Written Test retake only $40; Oral Test retake only $40, and 'You may select this option even if you previously took the Written test.' Rescheduling — 'An additional rescheduling/no show fee of $25 is required to reschedule an exam appointment with less than five business days notice, no-shows, late arrivals, or not allowed to test', while the candidate bulletin (revised July 2018; the application is dated January 2018) prices late changes differently: 'A $25 fee to reschedule up to five full working days before your test' but 'A full exam fee if you reschedule less than five full working days before your test, or if on the day of your test you are denied admission into a test site for arriving after the scheduled start time or for not providing valid ID', and 'If you miss your test or are late and not allowed to test, you will lose your fees and must pay a new fee to test.' The two documents disagree on what a late change or no-show costs, and both are stated here. The bulletin also lists an Appeals/Handscore fee of $25. Payment is by American Express, Visa or MasterCard, or by money order or certified check payable to the contractor; 'Personal checks and cash are not accepted' and 'Testing fees are nonrefundable and nontransferable.' Reciprocity fee, paid to the state: 'The Reciprocity Processing fee is $30; please submit payment along with all other documents. Payment should be in the form of a check or money order, and made payable to: STATE OF DELAWARE. Please note that all fees made payable to the State of Delaware are non-refundable if your application is denied for any reason.' The reciprocity route also requires a National Practitioner Data Bank self-query, for which 'there is a cost' the Department does not state. Renewal fee: $25.00, and it is paid at the state's continuing-education website rather than to the Division. The Division of Health Care Quality states the amount on its own letterhead in two documents. Its Nurse Aide Certification Renewal notice (3/2023) reads: 'In addition to the work requirement and the continuing education requirement, you must pay a $25.00 renewal fee. This must be paid online at https://decnarecert.academy.reliaslearning.com using a credit/debit card. Once you have completed all steps for recertification and your information is verified, your renewal will be processed; allow up to 48 hours for this process to be completed.' Its notice of the January 2020 changeover reads: 'As of January 1, 2020, CNAs will no longer be sending their payments or renewal forms to the Division of Health Care Quality. Both the $25.00 renewal fee and renewal form will be completed through the RELIAS website.' The statute sets the fee's legal footing and explains how the amount is arrived at: 'Upon receipt of an application and fee, the Department shall verify the accuracy of the information set forth in the application and issue to the applicant a certificate of renewal for 2 years' (16 Del. C. 3006A(b)); 'The required renewal fee must accompany the application for renewal' (16 DE Admin. Code 3220, 2.3.2.1); and the fee 'shall approximate and reasonably reflect all costs necessary to defray the expenses of maintaining an educational website from which certified nursing assistants will receive the required educational credits', 'shall not be combined with any other fee or charge', with 'At the beginning of each biennial calendar year, the Department or any other state agency acting on its behalf, shall compute the appropriate fee for the coming 2 years' (3006A(b)(2)). That design matches what Delaware actually charges: the $25.00 is paid at exactly the educational website the statute describes. Because the statute directs a biennial recomputation the figure can move, but the Department has published the same $25.00 from the January 2020 notice through the 3/2023 renewal form, and $25.00 is the published amount as of August 16, 2026. Late renewal penalty — a separate charge that happens to be the same number: a '$25 penalty fee' on top of the $25.00 renewal fee, for a renewal filed within 30 days after expiry (16 Del. C. 3006A(c); 3220, 2.3.6.1). The two $25 amounts are coincidentally equal and are not the same charge; a CNA who renews late pays both. Training cost is set by the approved program and is not published by the Department — but see the reimbursement rule under Requirements in detail, under which a federally certified nursing facility that hires the new CNA within 12 months must repay documented tuition, testing and textbook costs.",
   "legal_basis": "[{\"citation\": \"16 Del. C. ch. 30A, subchapter I (Training and Qualifications for Nursing Assistants and Certified Nursing Assistants), sections 3001A through 3007A\", \"what_it_governs\": \"The definitions of certified nursing assistant, nursing assistant and senior certified nursing assistant (3001A); the training requirement and its delegation of the hour count to a written order signed by the Secretary with a floor set by the Centers for Medicare and Medicaid Services (3002A); the course and curriculum requirements including compliance with 42 C.F.R. 483.152 and the 24:1 classroom and 8:1 clinical instructor ratios (3003A); the mandatory orientation period, the 90-day certification deadline for a trained nursing assistant, and the two-hour temporary-agency orientation (3004A); the senior certified nursing assistant designation and its 50 additional hours (3005A); biennial recertification, the military-service deferral, how the renewal fee is computed, the 30-day late-renewal window with its $25 penalty, and the consequence of lapse (3006A); and the Department's rulemaking mandate (3007A). The act that moved the hour count out of the Code and into the Secretary's written order is 83 Del. Laws, c. 267 (House Bill No. 280, approved January 24, 2022): its strike-through text deletes 'a total of 150 clock hours of training, 75 of which are in the classroom and 75 of which include clinical training' and inserts 'The total clock hours of classroom and clinical training required for certification shall be determined by the Department through written order signed by the Secretary.' The same act deleted the statutory orientation hour figures for the same reason. 83 Del. Laws, c. 493 (House Bill No. 279 as amended, an act relating to certification of central service technicians) is a different act with a different subject: its effect on this chapter is structural, 'renaming and redesignating the existing chapter as “Subchapter I”' and adding the central service technician subchapter, which is why 'c. 493' appears in the history line of every section from 3001A to 3007A without having changed any of their substance.\", \"url\": \"https://delcode.delaware.gov/title16/c030a/sc01/index.html\"}, {\"citation\": \"16 DE Admin. Code 3220 — Training and Qualifications for Certified Nursing Assistants (Division of Health Care Quality), last amended at 26 DE Reg. 107 (08/01/22)\", \"what_it_governs\": \"The operating rules: definitions including 'Facility', 'Nursing Related Services' and 'Full-Time' (35 clock hours per week); initial certification, the 24-month validity of a certificate of completion, the three-attempt test limit and the retraining consequence, the deemed routes for nursing students and RN/LPN graduates, foreign-trained nurses, and the two-year certification term; reciprocity and its 420-clock-hour experience test; renewal, the 24 hours of continuing education with six dementia and two abuse-prevention hours, the 64-hour work requirement, the 30-day late window and lapse; training program approval, instructor qualifications, ratios, minimum equipment, curriculum content with the hours delegated to the Secretary's written order, immunization and tuberculosis requirements; the mandatory orientation period and the employer reimbursement rule; and discipline, sanctions and administrative hearings.\", \"url\": \"https://regulations.delaware.gov/AdminCode/title16/3000/3220.shtml\"}, {\"citation\": \"42 C.F.R. 483.152 (federal nurse aide training and competency evaluation program requirements), as applied by Delaware\", \"what_it_governs\": \"The federal standard Delaware incorporates twice — the statute requires that 'All courses in this State offering certification to individuals as certified nursing assistants must meet the requirements of 42 C.F.R. Ch. IV 483.152' (16 Del. C. 3003A), and the regulation applies it to reciprocity: an out-of-state CNA 'must have completed a program that equals or exceeds the federal nurse aide training program requirements in the Code of Federal Regulations 483.152' (16 DE Admin. Code 3220, 2.2.2). It is also the reference point for the statutory floor on training hours, which may never fall below what the Centers for Medicare and Medicaid Services require. The federal text itself was not read as of August 16, 2026; it is cited here as Delaware cites it.\", \"url\": \"https://delcode.delaware.gov/title16/c030a/sc01/index.html\"}, {\"citation\": \"29 Del. C. ch. 101 (Administrative Procedures Act)\", \"what_it_governs\": \"The conduct of disciplinary hearings and the right of appeal from the Department's final decision: 'All hearings shall be conducted in accordance with the Administrative Procedures Act, 29 Del.C. Ch. 101' (16 DE Admin. Code 3220, 5.3.1), and the hearing officer must notify the parties of 'the right to an appeal pursuant to the Administrative Procedures Act' (5.3.10.2). The chapter text itself was not read as of August 16, 2026.\", \"url\": \"https://regulations.delaware.gov/AdminCode/title16/3000/3220.shtml\"}, {\"citation\": \"14 DE Admin. Code 804 and 16 DE Admin. Code 4202, adopted by reference into the CNA training rules\", \"what_it_governs\": \"Immunization requirements for students in Delaware CNA training programs. The regulation adopts both 'as the regulatory requirements for CNA Training programs in Delaware' and provides that 'Students that do not meet the minimum vaccination requirements shall not be permitted to participate in clinical training' (16 DE Admin. Code 3220, 3.14). Neither adopted text was read as of August 16, 2026, and nothing on this page is quoted from them.\", \"url\": \"https://regulations.delaware.gov/AdminCode/title16/3000/3220.shtml\"}]",
   "exam_vendor": "Prometric, under contract to the Department. The state-approved candidate bulletin states it: 'The DLTCRP has contracted with Prometric Inc. to develop and administer its Nurse Aide Competency Exam and to manage the CNA Registry.' The regulation names the role without naming the company — 'An application for testing shall be filed, along with a non-refundable fee, with the test vendor approved by the Department' (16 DE Admin. Code 3220, 2.1.3) — which is why the vendor can change without a rule change. Applications, exam fees, scheduling, score reports and the public registry lookup all run through the contractor; reciprocity, deemed certification and training-program approval go directly to the Division of Health Care Quality in Newark or Milford.",
   "training_hours": "91 clock hours minimum — 75 classroom and 16 clinical — and the number does not come from the statute. Delaware moved the figure out of its code: 'To obtain certification as a certified nursing assistant, all trainees must complete training in both classroom and clinical settings. The total clock hours of classroom and clinical training required for certification shall be determined by the Department through written order signed by the Secretary. At no time may the number of clock hours be less than those required by the Centers for Medicare and Medicaid Services' (16 Del. C. 3002A). The regulation repeats the delegation word for word for program curricula: 'The total, minimum clock hours of classroom instruction and clinical training required for certification shall be determined by the Department through written order signed by the Department Secretary. At no time may the number of clock hours be less than those required by the Centers for Medicare and Medicaid Services', adding that 'Additional hours may be added by the training program in either or both of the classroom instruction or clinical training components' (16 DE Admin. Code 3220, 3.11.1.2). The operative number is published on the Department's own current application form for training programs, dated 11/2025 and issued by the Division of Health Care Quality: 'The program must be a minimum of 91 hours divided between clinical (16 hours) and classroom (75 hours) instruction. Additional hours may be in either of these two areas or both.' The same form tells programs that 'lunch and break times are subtracted from total program hours', requires a schedule showing 'when students will receive CPR certification', and lists the five textbooks Delaware approved for 2025, none of which may be 'published beyond 5 years of the current date.' What this means for any '150 HOURS' you may have seen: that figure is not in the current Delaware Code, the current regulation, or the Department's current program application, none of which states it. Delaware's structure today is 75 classroom hours plus 16 clinical hours, which mirrors the federal floor's shape — 75 total clock hours including at least 16 hours of supervised practical training — while placing the 75 entirely on the classroom side, so the Delaware total sits above the federal minimum. A second Secretary's order sets a second number: the clinical practicum hours a nursing student must have to be deemed qualified are likewise 'determined by the Department through written order signed by the Secretary' (3220, 2.1.6.2), and the contractor's published figure for that route is 'no less than 75 hours of clinical instruction in a long term care setting.' The Department's own form gives a different number: its Application for Deemed Certification says a nursing student who has completed a Fundamentals of Nursing course and 'a minimum of 16 hours of clinical rotation in a CMS certified hospital or longterm care facility may apply for Deemed CNA status'. The two published figures do not agree, and neither document says which one controls. The written orders themselves are not published anywhere we could read — the Department's own website could not be reached as of August 16, 2026, so both hour figures here are taken from the Department's application forms rather than from the orders they implement.",
   "lapse_rule": "Delaware gives one short grace window and then makes you test again. The 30-DAY window: 'A certification may be renewed up to 30 days past the certification's expiration date by submitting, to the Department, payment of a $25 penalty fee along with an application and proof of completion of continuing education requirements during the previous certification period' (16 Del. C. 3006A(c)); the regulation limits it to people who actually met the requirements — 'a CNA who fails to renew the certification prior to the expiration date but has completed the requirements outlined in subsection 2.3.4 may still renew the certification up to 30 days past the certification's expiration' (16 DE Admin. Code 3220, 2.3.6). After that, the certificate is lapsed and the work stops: 'The certification of a certified nursing assistant who fails to renew on time or during the 30-day late renewal period is considered lapsed and the certified nursing assistant is not permitted to work until the certified nursing assistant submits an application and takes and passes the certified nursing assistant test' (16 Del. C. 3006A(c)); 'A CNA with a lapsed certification is not permitted to work as a CNA in the State of Delaware' and 'The CNA must take and pass the CNA competency test in order to work as a CNA in the State of Delaware' (3220, 2.3.8). The contractor calls this Route 3: 'Select this route if you were a certified nurse aide in Delaware but you did not perform at least 64 hours of nursing-related services during your last 24-month certification period. You must successfully retake the Competency Exam in order to be recertified', submitting proof of past certification with the application. Note that retraining is not automatically required — the lapsed CNA retests rather than repeating the course, unless they then fail three times: 'Individuals who fail to obtain a passing score on the written and/or clinical portions of the competency test after testing three times must repeat the CNA training program before additional testing will be permitted' (3220, 2.3.9). Discipline is a separate track with its own consequences. Grounds include 'Practicing as a CNA with an expired certification', 'Abuse, neglect, mistreatment or financial exploitation of a resident/patient', 'Allowing another person to use her/his CNA certification', 'Committing fraud, misrepresentation or deceit in taking the CNA test or in obtaining certification', 'Failing to report abuse, neglect, mistreatment or financial exploitation', and 'Having a certificate revoked or suspended in another state for reasons which would preclude certification in this state' (3220, 5.1). The available actions are refusal to issue, revocation or suspension, a letter of reprimand, refusal to renew, 'Placement on the Adult Abuse Registry' and 'Flag on the CNA Registry' (5.2). Process rights are set out in the regulation: notice by certified mail, a right to an administrative hearing requested in writing 'postmarked within 20 calendar days of the date of the notice', the right to examine documents, bring witnesses, cross-examine and be represented by counsel, and a written decision within thirty business days, with appeal under the Administrative Procedures Act, 29 Del. C. ch. 101 (5.3).",
   "reciprocity": "Delaware grants reciprocity, and its 2025 application is unusually specific about what qualifies. The regulation sets the test: an out-of-state CNA 'must have completed a program that equals or exceeds the federal nurse aide training program requirements in the Code of Federal Regulations 483.152', and the Department grants reciprocity where the CNA 'Has a current CNA certificate from the jurisdiction where he or she currently practices', with 'Applicants from the State of Maryland must hold a current Geriatric Nursing Assistant certificate'; 'Within the last 24 months, has completed 3 months of full-time experience, equal to 420 clock hours, as a CNA performing nursing related services for pay under the supervision of a nurse or physician, or has completed a training and competency evaluation program with the number of hours at least equal to that required by the State of Delaware'; 'Is in good standing in the jurisdiction where he/she is currently certified'; and 'Has submitted the required reciprocity fee' (16 DE Admin. Code 3220, 2.2). Reciprocity certification runs the same two years (2.2.4). The Department's current application (revised November 24, 2025) restates the same rules and adds the paperwork: listing on another state's registry as 'CURRENT or ACTIVE, and in good standing'; 'Have no pending or substantiated findings of adult/child abuse, neglect, financial exploitation, and/or misappropriation of resident/patient property recorded on any State's Nurse Aide Registry'; 420 hours of paid CNA work in the last 24 months under the direct supervision of a nurse or physician, OR completion of an approved training and competency evaluation program 'of at least 75 total clock hours'; a notarised Employer Verification Form covering dates, status, job title and total hours ('W-2's will not be accepted'); a notarised Training Program Verification Form where the 420 hours are not met; a copy of the current out-of-state certificate and a list of every state where the applicant has ever been certified; a government-issued photo identification; 'THE SEALED/UNOPENED COPY of the National Practitioner Data Base (NPDB) self-query' with the instruction 'DO NOT OPEN THE ENVELOPE WHEN YOU RECEIVE IT'; and the $30 fee payable to the State of Delaware. 'Incomplete applications will be destroyed after six (6) months of inactivity.' A different route for people without the experience: a CNA certified in another state 'who does not have three months of full-time employment' is eligible to sit the Delaware exam without taking a Delaware training program — the contractor's Route 4. And a bar on using reciprocity as an escape hatch: 'A CNA, who is certified in Delaware, may not use the certification from another State for the purpose of applying for reciprocity to avoid Delaware's continuing education requirements' (3220, 2.3.10).",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Delaware Code, Title 16, Chapter 30A, Subchapter I — Training and Qualifications for Nursing Assistants and Certified Nursing Assistants (Delaware Code Online). Establishes the definitions of 'certified nursing assistant', 'nursing assistant' and 'senior certified nursing assistant'; that total training clock hours 'shall be determined by the Department through written order signed by the Secretary' with a Centers for Medicare and Medicaid Services floor; the 42 C.F.R. 483.152 compliance requirement and the 24:1 and 8:1 instructor ratios; the mandatory orientation period, the 90-calendar-day certification deadline and the two-hour temporary-agency orientation; the senior CNA designation with its three years, 50 hours and competency test; and biennial recertification with the military deferral, the fee-computation rule, the 30-day $25 late window and the lapse consequence.\", \"url\": \"https://delcode.delaware.gov/title16/c030a/sc01/index.html\"}, {\"label\": \"16 DE Admin. Code 3220 — Training and Qualifications for Certified Nursing Assistants, Division of Health Care Quality (Delaware Administrative Code), amendment history line 26 DE Reg. 107 (08/01/22). Establishes essentially every operational rule quoted on this page: the facility definition, 'Delaware CNA certification is required prior to being employed as a CNA in the State', the 24-month validity of the certificate of completion, the three-attempt limit and retraining rule, the deemed routes, foreign-trained nurse eligibility, the two-year term, the reciprocity conditions including the 420-clock-hour experience test, the renewal requirements (24 continuing education hours with six dementia and two abuse-prevention hours, plus 64 hours of paid nursing-related services), the 30-day late window and lapse, the training program rules and instructor ratios, the delegation of curriculum hours to the Secretary's written order, immunization and tuberculosis requirements, the orientation rules and the facility reimbursement obligation, and the discipline grounds, sanctions and hearing procedure.\", \"url\": \"https://regulations.delaware.gov/AdminCode/title16/3000/3220.shtml\"}, {\"label\": \"Delaware Department of Health and Social Services, Division of Health Care Quality — Application for Approval Under the Omnibus Budget Reconciliation Act for the Nurse Aide Training Program, dated 11/2025. The Department's own current form for approving CNA training programs. Establishes the operative training-hours figure — 'The program must be a minimum of 91 hours divided between clinical (16 hours) and classroom (75 hours) instruction. Additional hours may be in either of these two areas or both' — plus the five Delaware-approved 2025 textbooks and the five-year publication limit, the requirement that 'lunch and break times are subtracted from total program hours', the CPR certification scheduling requirement, the 90-day processing time, the primary didactic instructor qualifications (two years of registered nurse experience, at least one in federal skilled nursing facility services, plus one year teaching adults or a Department-approved 'Train the Trainer' certificate) and the secondary clinical instructor qualifications (two years registered nurse or three years licensed practical nurse experience), and the Division's Newark and Milford office addresses and phone numbers.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/Delaware-NATCEP-Application.pdf\"}, {\"label\": \"Delaware Department of Health and Social Services, Division of Health Care Quality — Delaware Nurse Aide Application for Certified Nurse Aide Reciprocity, revised 11-24-2025. Establishes the current reciprocity conditions in the Department's own words: current or active listing on another state's registry in good standing, the Maryland Geriatric Nurse Aide requirement, 'no pending or substantiated findings of adult/child abuse, neglect, financial exploitation, and/or misappropriation', the 420-hour work-experience test within the last 24 months OR a NATCEP 'of at least 75 total clock hours', the notarised employer and training program verification forms, the rejection of W-2s as employment evidence, the sealed unopened National Practitioner Data Bank self-query, the '$30' reciprocity processing fee payable to the State of Delaware and its non-refundability, the six-month destruction rule for incomplete applications, and the Division's Milford and Newark mailing addresses.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/DE-CNA-Reciprocity-Application.pdf\"}, {\"label\": \"State of Delaware Nurse Aide Registry, Division of Health Care Quality, Office of Long Term Care Residents Protection — Application for Deemed Certification. Establishes the deemed routes in the Department's own words: an RN or LPN graduate within 24 months is 'deemed qualified to meet the Department's nurse aide training and competency evaluation program requirements and are eligible for certification upon submission of a sealed copy of their diploma'; a graduate more than 24 months out is eligible to take the competency test; a nursing student who has completed a Fundamentals of Nursing course and 'a minimum of 16 hours of clinical rotation in a CMS certified hospital or longterm care facility may apply for Deemed CNA status'; the $115 competency examination fee where required; and the warning that 'You cannot be employed as a CNA in the State of Delaware before you receive verification that your application has been approved and that you have been placed on the registry.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/DE-Deemed-CNA-Application.pdf\"}, {\"label\": \"Candidate Information Bulletin — State of Delaware Certified Nurse Aide Examination (Prometric, revised 07182018, published on the Delaware nurse aide exam page the Department's contractor maintains). Establishes the contract scope ('The DLTCRP has contracted with Prometric Inc. to develop and administer its Nurse Aide Competency Exam and to manage the CNA Registry'), the seven eligibility routes and which two skip the exam, the three-attempts-in-24-months rule, the exam structure ('The Written test consists of 60 multiple-choice questions. You will have 90 minutes'; five clinical skills with Handwashing and Indirect Care; 'You must pass all five skills'), the English-only rule and the oral alternative, the fee schedule and rescheduling rules, the appeals process and its 60-day deadline, the renewal requirements including the 64-hour work rule and the 24 continuing education hours with six dementia and two abuse-prevention hours, the registry verification pointer and phone number 302.577.6661, and the training and testing fee reimbursement rules for candidates hired by federally certified nursing facilities.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/DE_CNA_CIB.pdf\"}, {\"label\": \"Delaware Nurse Aide Exam Application (the printable application form on the Delaware nurse aide exam page, Rev. 01032018). Establishes the live exam fee schedule — Written Test and Clinical Skills Test $115, Oral Test and Clinical Skills Test $115, Clinical Skills retake $75, Written retake $40, Oral retake $40, and the '$25' rescheduling/no-show fee for less than five business days' notice — plus the five routes filed with the contractor and the documents each requires, the regional test site codes in New Castle, Kent and Sussex counties, the training instructor certification line, and the candidate affidavit ('I understand if I pass both parts of the Nursing Assistant Competency Exam, I will be placed on the Delaware Nursing Assistant Registry').\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/DE_CNA_APP.pdf\"}, {\"label\": \"Delaware Nurse Aide exam page (Prometric, the contractor the Department names for testing and registry management). The page that publishes the Delaware candidate bulletin, the examination application and its online version, the reciprocity and deemed certification applications, the nurse aide training program application, the state-approved CNA program list, the regional testing location list, the clinical skills checklist and instructions, and the link to the Delaware CNA Registry lookup.\", \"url\": \"https://www.prometric.com/exams/nurseaide-de\"}, {\"label\": \"Delaware State Nurse Aide Registry public lookup (Prometric, on behalf of the Department). Establishes the search fields, the employer-code option, and the notice that 'The Dept of Health requires that all employers search the registry prior to employing a Nurse Aide.'\", \"url\": \"https://registry.prometric.com/registry/publicDE\"}, {\"label\": \"Delaware Code, Title 16, Chapter 30A (chapter index) — 'Training and Certification Requirements for Certain Nurse Assistants and Central Service Technicians', showing that Subchapter I covers nursing assistants and certified nursing assistants and Subchapter II covers the separate certification of central service technicians.\", \"url\": \"https://delcode.delaware.gov/title16/c030a/index.shtml\"}, {\"label\": \"Delaware Department of Health and Social Services, Division of Health Care Quality — Nurse Aide Certification Renewal notice, 3/2023. The Division's own renewal letter to certificate holders. It is a scan of a paper document, so its text cannot be selected or searched. Establishes the $25.00 renewal fee and that it is paid online at the Relias site by credit or debit card; that all Delaware CNAs are registered in Relias at https://decnarecert.academy.reliaslearning.com with the temporary password 'WELCOME1' and the Relias Helpdesk at 1-844-735-2223; the 30-day-before-expiry filing rule; the 64 paid hours in the last 24 months under direct supervision of a Registered Nurse or Physician and the 24 continuing education hours from a State approved vendor; the up-to-48-hour processing time and the 'ACTIVE' registry result for another two years; and that 'the state of Delaware does not provide certification cards', so the registry lookup is the proof of certification.\", \"url\": \"https://www.prometric.com/files/RenewalNotification.pdf\"}, {\"label\": \"Delaware Department of Health and Social Services, Division of Health Care Quality — notice of the January 1, 2020 continuing-education changeover ('Important Updates'). On DHSS / Division of Health Care Quality letterhead. Like the renewal notice, it is a scan of a paper document, so its text cannot be selected or searched. Establishes that the CEU vendor changed from Elsevier to Relias on January 1, 2020 and that from that date 'CNAs will no longer be sending their payments or renewal forms to the Division of Health Care Quality. Both the $25.00 renewal fee and renewal form will be completed through the RELIAS website'; that CEU classes are 'presented in a bundled package selected by DHCQ'; the college-transcript upload option; Relias customer service hours; the 64-hour Employment Verification Statement mechanic and the revocation warning for falsifying it; the consequence of missing either requirement ('they will have to retake the CNA exam offered by Prometric'); and the corroborating statement 'Currently the cost to test for the CNA exam is $115.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/ImportantUpdatesDelaware.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/de-cna/"
  },
  {
   "page_id": "fl-cna",
   "state": "Florida",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Florida Board of Nursing, Florida Department of Health (Division of Medical Quality Assurance) — the Board maintains the Certified Nursing Assistant Registry",
   "board_url": "https://floridasnursing.gov/licensing/certified-nursing-assistant/",
   "application_url": "https://floridasnursing.gov/licensing/certified-nursing-assistant/",
   "renewal_cycle": "Biennial, filed with the Board of Nursing (not with Prometric), for $50 — and the renewal is a declaration that you worked. Fla. Stat. 464.203(8): 'The department shall renew a certificate upon receipt of the renewal application and imposition of a fee of not less than $20 and not more than $50 biennially. The department shall adopt rules establishing a procedure for the biennial renewal of certificates.' Rule 64B9-15.0045(1) fixes the fee at $50.00. Prometric describes what the renewal actually asks for: 'To renew, you will have to pay a fee and complete a form documenting that you have worked for pay during your certification period performing nursing-related services.' The Board handles renewals; certificates carry expiration dates and 'To keep your certificate current (active), you will need to renew your certificate before the expiration date.' A separate, employer-side obligation runs alongside it for nursing home staff: 'When employed by a nursing home facility for a 12-month period or longer, a nursing assistant, to maintain certification, shall submit to a performance review every 12 months and must receive regular inservice education based on the outcome of such reviews' (Fla. Stat. 400.211(4)). That inservice must 'Be sufficient to ensure the continuing competence of nursing assistants' and must include, at a minimum, techniques for assisting with eating and proper feeding; principles of adequate nutrition and hydration; techniques for assisting and responding to the cognitively impaired resident or the resident with difficult behaviors; techniques for caring for the resident at the end-of-life; recognizing changes that place a resident at risk for pressure ulcers and falls; and recognizing signs and symptoms of venous thromboembolism and techniques for providing an emergency response. Costs 'may not be reimbursed from additional Medicaid funding through interim rate adjustments.'",
   "ce_hours": "24 hours of in-service training per biennium, prorated for a first partial cycle. Fla. Stat. 464.203(7): 'A certified nursing assistant shall complete 24 hours of inservice training during each biennium. The certified nursing assistant shall maintain documentation demonstrating compliance with this subsection.' Rule 64B9-15.011(1) adds the proration: 'For candidates certified during the biennium period, the training shall be prorated to 1.0 hours of in-service training per month from the month of initial certification to the end of the biennium.' Required subject areas — 64B9-15.011(2), and, until September 2026, repeated verbatim on the Board's CNA licensing page: 'Bloodborne Pathogens, Infection Control; Domestic Violence; Medical Record Documentation and Legal Aspects Appropriate to Nursing Assistants; Resident Rights; Communication with Cognitively Impaired Clients; CPR Skills; and, Medical Error Prevention and Safety.' The list is a floor, not a ceiling — the statute-side language is 'shall include, but are not limited to' — and once those areas are covered, '(3) health care career/technical courses in a college, university, or approved nursing program may be used to meet the hour requirement.' Two military exemptions, both unusual enough to be worth stating: a CNA is exempt 'if the certified nursing assistant was on active duty with the Armed Forces for 6 months or more during the calendar year, and was in good standing with the Board at the time active duty began' — but 'this exemption will not arise on the basis of the performance of short periods of active duty (such as summer or weekend drills)... Duty in the United States Public Health Service is not considered duty in the Armed Forces' (64B9-15.011(4)); and a CNA who is the spouse of an Armed Forces member 'and was caused to be absent from Florida due to the spouse's duties' is exempt on satisfactory proof (64B9-15.011(5)). Records: 'Each certified nursing assistant must retain in-service compliance records for a period of 4 years and submit records to the Board if required for auditing' (64B9-15.011(6)). Medication-administration hours are extra: a CNA who administers medication must 'annually and satisfactorily complete 2 hours of inservice training in medication administration and medication error prevention approved by the board', and that 'inservice training is in addition to the other annual inservice training hours required under this part' (Fla. Stat. 464.2035(2)).",
   "exam": "Two parts — a Written (Knowledge) Test and a Clinical Skills Test — and both must be passed within a two-year window. Rule 64B9-15.008(1) F.A.C.: 'The Certified Nursing Assistant Examination shall consist of the Written Exam and the Clinical Skills Test. Both the Written Exam and the Clinical Skills Test must be passed within a two-year period in order to achieve certification. Results on either the Written Exam or the Clinical Skills Test which are over two years old are invalid and both the Written Exam and the Clinical Skills Test must be repeated.' Written test — the Board describes it precisely: 'The Written Test is a ninety (90) minute test with sixty (60) multiple-choice questions written in English. An Oral or Spanish Test may be requested for the Written Test if you have difficulty reading English and you must ask for it when you submit your application.' The statute guarantees the oral option: 'An oral examination shall be administered as a substitute for the written portion of the examination upon request' (Fla. Stat. 464.203(3)). The rule names five content areas in its own words — 'Role of the Nursing Assistant; Promotion of Safety; Promotion of Function and Health of Residents; Basic Nursing Care Provided for Residents with Changes in Health; and, Specific Care Provided for Residents with Changes in Health' (64B9-15.008(2)) — and Prometric's outline weights its five as: Role of the Nurse Aide 20%, Promotion of Safety 22%, Promotion of Function and Health of Residents 20%, Basic Nursing Care Provided by the Nurse Aide 24%, Providing Specialized Care for Residents with Changes in Health 14%. The two lists differ in three of the five names; each is given here as its source states it. Passing score — Florida publishes it, which few states do: 'For the written exam, the Board adopts a passing minimum score on the base from of 76%, equating for subsequent forms' (64B9-15.008(3)). Clinical skills test — 'The Manual Skills Evaluation requires the applicant to perform five (5) randomly selected nursing assistant skills' (Board), and the rule specifies the structure: 'The Clinical Skills Test includes three of the following tasks in addition to hand washing and indirect care', drawn from Personal Care (perineal care female, catheter care, dressing, partial bed bath, toileting bedpan, mouth care brushing teeth, mouth care care of dentures, grooming hair and nail care, feeding, change occupied bed, foot care — the rule's eleven Personal Care tasks), Promotion of Function, Health, and Safety (change of position, transfer, range of motion upper extremity, range of motion lower extremity, ambulation) and Reporting and Recording (measure and record pulse and respirations, weight, content of urinary drainage bag, blood pressure) (64B9-15.008(4)). The skills passing standard is form-dependent: 'the recommended minimum passing level for each task is 3 Standard Errors of Measure below the mean... The candidate must have a minimum passing score on each of the five tasks on an examination form to pass the Clinical Skills Test' (64B9-15.008(5)). Who watches — a Clinical Skills Observer must be a Florida-licensed registered nurse with at least two years of nursing experience and at least one year in long-term care or caring for the chronically ill, with no personal or professional relationship to the candidate (64B9-15.008(7)). Attempts — three, then training: 'If an applicant fails to pass the nursing assistant competency examination in three attempts, the applicant is not eligible for reexamination unless the applicant completes an approved training program' (Fla. Stat. 464.203(2); rule 64B9-15.008(6)). A failed written test can be reviewed: request it by email within 21 days of the test, complete the review within 60 days, and you are 'given a printout of the test showing the questions missed, incorrect answers given, and correct answers.' ESL accommodation is separate from ADA accommodation — extra time is available on proof that English is not the candidate's primary language, and 'Exams scheduled before the ESL request has been approved will not include extra time.'",
   "fees": "Florida charges nothing to certify, but $50 to renew. The Board states that for initial certification 'All fees are paid directly to Prometric and the Livescan service provider', and for the endorsement route that 'Applicants are responsible for fees required by the Livescan provider for electronic fingerprinting process. Fees may vary from provider to provider.' Renewal fee — rule 64B9-15.0045 F.A.C.: '(1) For renewal of Certified Nursing Assistant Certificate, as provided in Section 464.203(8), F.S., the fee is $50.00. (2) The fee for change in status on a delinquent license, as provided in Section 456.036(8), F.S. is $50.00.' The statute frames it as a range — the department shall renew 'upon receipt of the renewal application and imposition of a fee of not less than $20 and not more than $50 biennially' (464.203(8)) — and the Board has set it at the top of that range. Exam fees, paid to Prometric with the application — ⚠ the bulletin states its payment methods two ways: the narrative fee section says 'Payment may be made by including a Visa, MasterCard or American Express number, money order, company check or cashier's check. Personal checks, purchase orders, vouchers and cash are not accepted', while the bound-in application form says 'Acceptable Forms of Fee(s) Payment: certified check, money order, MasterCard, Visa or American Express... Personal checks and cash are not accepted.' Both are recorded; neither is merged into the other. The fees themselves: Clinical Skills (English only) and Written Test (audio, English or Spanish) together $155; Written Test alone (English or Spanish, standard or audio) $35; Clinical Skills Test alone (English only) $120. 'Fees are non-refundable and non-transferrable.' Rescheduling — ⚠ Prometric's own bulletin contradicts itself: the fee table lists 'Rescheduling Fee (see Page 4) $30' and the narrative says '$30 fee to reschedule up to five full working days before your test', while the application form inside the same bulletin says 'An additional rescheduling/no show fee of $25 is required to reschedule an exam appointment with less than five business days notice, no-shows, late arrivals, or not allowed to test.' Both figures are recorded; neither is chosen. Rescheduling inside five working days otherwise costs 'A full exam fee', and a missed test forfeits the fee — though 'The rescheduling fee may be waived with proof of your illness or emergency.' Exam review — the fee table says 'Exam Review $25' while the narrative says 'The fee for a written test review is $30'; again a same-document conflict, recorded both ways. Optional practice materials: a 50-question written practice exam is $10, 'A super pack of all 3 practice exams is available for $25', and Clinical Skills Readiness tests are '$5 to $7 with a super pack of all skills available for $25.' A name-change certificate is $25; updating the registry with a name or address change is free. And the one that saves real money: 'If a nursing home employs you within 12 months of getting your certification, the facility is required to pay for your training and testing fees under federal law.'",
   "legal_basis": "[{\"citation\": \"Fla. Stat. ch. 464, pt. II (Certified Nursing Assistants), ss. 464.201-464.208\", \"what_it_governs\": \"The whole Florida CNA scheme: definitions and the registry (464.201), the Board's duties including maintaining the registry and contracting for examinations (464.202), the certification requirement and its four routes, the three-attempt limit, the oral-exam right, the 24-month work rule, the address duty, the 24-hour biennial inservice requirement and the $20-$50 biennial renewal fee (464.203), medication administration by a CNA (464.2035), discipline (464.204), availability of disciplinary records (464.205), exemption from liability (464.206), penalties (464.207) and background screening rulemaking (464.208).\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/Chapter464/PART_II\"}, {\"citation\": \"Fla. Stat. 464.203 (Certified nursing assistants; certification requirement), history through s. 7, ch. 2024-274\", \"what_it_governs\": \"The read-and-write minimum, the s. 400.215 background screening and its 90-day waiver, the four qualifying routes including the diploma-or-age-18 exam-only route, the six-month skills-test waiver, the three-attempt bar, the oral examination right, the 24-consecutive-month non-practice rule, the address-of-record duty, the 24-hour biennial inservice duty and the biennial renewal fee range.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.203\"}, {\"citation\": \"Fla. Stat. 400.211 (Persons employed as nursing assistants; certification requirement; qualified medication aide designation and requirements)\", \"what_it_governs\": \"Where the duty to be certified actually sits — nursing homes — plus the licensed-nurse exclusion, the four categories that may be employed uncertified for a single consecutive four-month period, the employer's employment-history verification duty, the 12-month performance review and inservice content for nursing-home CNAs, and the Qualified Medication Aide designation with its one-year certification prerequisite and 34-hour course.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/400.211\"}, {\"citation\": \"Fla. Admin. Code ch. 64B9-15 (Certified Nursing Assistants) — Board of Nursing rules\", \"what_it_governs\": \"The chapter comprises 64B9-15.001 Definitions (eff. 3/13/2024);.0015 Standards of Practice (8/22/2021);.002 Authorized Duties (3/13/2024);.0025 CNA Medication Administration (7/22/2024);.0026 Medication Administration Outside the Scope of Practice of a CNA (3/13/2024);.003 Eligibility for Certification (repealed 11/1/2015);.0035 Certification by Endorsement (1/12/2026);.004 Certified Nursing Assistant Registry (8/23/2007);.0045 Renewal Fee (5/19/2019);.005 Standards for CNA Training Programs (3/24/2024);.006 Standardized Curriculum (2/2/2022);.007 Approval and Renewal of New CNA Training Programs (11/28/2019);.008 Testing and Competency Evaluation (8/24/2017);.009 Disciplinary Guidelines (1/1/2026);.0095 Citation for Certified Nursing Assistants (1/1/2026);.0096 Mediation (7/2/2017);.0097 Notice of Non-Compliance (8/24/2017);.011 In-Service Training Requirements (7/4/2016);.012 Standards for In-Service Training (10/27/2013).\", \"url\": \"https://www.flrules.org/gateway/ChapterHome.asp?Chapter=64B9-15\"}, {\"citation\": \"Fla. Admin. Code r. 64B9-15.006 (Standardized Curriculum), effective 2/2/2022\", \"what_it_governs\": \"The size and shape of an approved training program: 'a minimum of 80 hours of classroom and 40 hours clinical instruction' with 'at least 20 hours of long term care clinical instruction in a licensed nursing home'; the 16 pre-contact classroom hours; the Department of Education curriculum framework (rule 6A-6.0571); and direct instructor supervision of clinical experience.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.006\"}, {\"citation\": \"Fla. Admin. Code r. 64B9-15.008 (Testing and Competency Evaluation), effective 8/24/2017\", \"what_it_governs\": \"The two-part examination, the two-year validity of each part, the written content areas, the 76% base-form passing score, the three-tasks-plus-handwashing-and-indirect-care structure of the skills test and its task list, the standard-error-based skills passing level, the three-attempt bar, and the qualifications required of a Clinical Skills Observer.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.008\"}, {\"citation\": \"Fla. Admin. Code r. 64B9-15.011 (In-Service Training Requirements for Certified Nursing Assistants), effective 7/4/2016\", \"what_it_governs\": \"The 24 hours per biennium, the 1.0-hour-per-month proration for a first partial cycle, the seven required subject areas, the college-coursework substitution once those areas are met, the two military exemptions, and the four-year record-retention and audit duty.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.011\"}, {\"citation\": \"Fla. Admin. Code r. 64B9-15.0045 (Certified Nursing Assistant Renewal Fee), effective 5/19/2019\", \"what_it_governs\": \"The $50.00 renewal fee and the separate $50.00 fee for change in status on a delinquent license.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.0045\"}, {\"citation\": \"Fla. Admin. Code r. 64B9-15.0035 (Certification by Endorsement), effective 1/12/2026\", \"what_it_governs\": \"The mobile endorsement route — form DH-MQA-5102 (Revised 8/2025) and compliance with all requirements of Fla. Stat. 456.0145(2).\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.0035\"}, {\"citation\": \"Fla. Stat. 456.0145 (licensure by endorsement — mobile) and 456.0635 (disqualification from licensure), as applied by the Board\", \"what_it_governs\": \"The interstate endorsement conditions the Board reproduces on its CNA endorsement page (active unencumbered out-of-state license, two years of active practice in the preceding four, no National Practitioner Data Bank report, no pending discipline, no discipline in the preceding five years, Level II screening) and the seven-day issuance promise under 456.0145(2)(e); plus the felony and Medicaid-exclusion bars in 456.0635. The sections' own texts were not separately read for this page; the content comes from the Board's page and from rule 64B9-15.0035.\", \"url\": \"https://floridasnursing.gov/licensing/certified-nursing-assistant/\"}]",
   "exam_vendor": "Prometric, under contract to the Florida Department of Health. Prometric's own Florida page states the relationship: 'The Florida Department of Health (DOH) has contracted with Prometric to develop and administer its Certified Nursing Assistant (CNA) Exam.' The Board points candidates to Prometric for the application and bulletin and publishes the contact details — prometric.com/nurseaide/fl, FLCNA@prometric.com, (888) 277-3500. The statutory basis for outsourcing is Fla. Stat. 464.202, which lets the Board 'contract with or approve another entity or organization to provide the examination services' and requires that the contract provider 'offer certified nursing assistant applications via the Internet' and 'provide the preliminary results of the certified nursing examination on the date the test is administered.' Note that Florida splits the roles unusually: the vendor takes the application and the fee; the Board determines eligibility, issues the certificate and runs the registry. Prometric is named as subject matter because Florida names it; it is not ranked or recommended.",
   "training_hours": "Florida sets no training-hour requirement for certification itself — and that is the single most important fact about this state. A person can be certified with zero hours of nurse aide training by passing the competency examination and either holding a high school diploma or equivalent or being at least 18 (Fla. Stat. 464.203(1)(b)); Prometric calls it the Challenger route and describes it as being for someone who has 'never been trained as a nursing assistant in Florida or any other state and have no nursing assistant experience and believe that you can pass the exam without training.' Hours attach to programs, not to people. If a candidate does take a state-approved program, rule 64B9-15.006(2) F.A.C. sets its size: 'The standardized curriculum shall require a minimum of 80 hours of classroom and 40 hours clinical instruction. The clinical instruction shall include at least 20 hours of long term care clinical instruction in a licensed nursing home' — 120 hours in total, with a nursing-home clinical floor inside the 40. Before any resident contact, 'a training program shall require that a student receive a minimum of 16 hours of classroom instruction in communication and interpersonal skills; infection control; safety/emergency procedures, including the Heimlich maneuver; promoting residents independence; and respecting residents rights' (64B9-15.006(3)), and 'Clinical experience shall be provided under the direct supervision of the program instructor' (64B9-15.006(4)). The curriculum itself 'shall follow the curriculum framework established by the Department of Education (Rule 6A-6.0571, F.A.C., effective 5/19/15)'. The 120 hours become compulsory after three failures: Fla. Stat. 464.203(2) provides that 'If an applicant fails to pass the nursing assistant competency examination in three attempts, the applicant is not eligible for reexamination unless the applicant completes an approved training program', and Prometric states the size — 'If you fail one portion of the test three times, you will have to do a state-approved training program that is at least 120 hours long. You will then need to take both the written and clinical tests again.' A spent provision worth knowing about because it still appears in the current rule text: 64B9-15.006(2)(a) permitted the 20 long-term-care clinical hours to be met by clinical simulation 'For 2021 2022 calendar years' — that window has closed, and the simulation definition in (b) and (c) survives only in relation to it. Note what this page does not say: the federal floor is 75 hours, and Florida's program minimum of 120 exceeds it — but Florida does not require any individual to complete a program, so there is no single 'Florida CNA training hours' number for a person.",
   "lapse_rule": "Florida has two different failure modes and they have different consequences. (1) not renewing on time — the certificate goes delinquent. Prometric: 'Certificates that are not renewed before they expire will be considered delinquent. You may not work with a delinquent certificate.' Coming back from delinquency costs an extra $50 on top of the renewal fee: 'The fee for change in status on a delinquent license, as provided in Section 456.036(8), F.S. is $50.00' (rule 64B9-15.0045(2)). (2) not working for 24 months — the certificate becomes unrenewable and the person must test again. Fla. Stat. 464.203(5): 'Certification as a nursing assistant, in accordance with this part, may be renewed until such time as the nursing assistant allows a period of 24 consecutive months to pass during which period the nursing assistant fails to perform any nursing-related services for monetary compensation. When a nursing assistant fails to perform any nursing-related services for monetary compensation for a period of 24 consecutive months, the nursing assistant must complete a new training and competency evaluation program or a new competency evaluation program.' Note the wording carefully: it is a new training and competency evaluation program **OR** a new competency evaluation program — Florida leaves retesting alone as an option rather than forcing retraining, which matches its exam-first posture everywhere else. Prometric provides the application route for it as certification route E5: 'Select this certification route if you were a certified nursing assistant in Florida or any other state and your certification has lapsed.' A third, separate expiry runs on exam results rather than on the certificate: 'Results on either the Written Exam or the Clinical Skills Test which are over two years old are invalid and both the Written Exam and the Clinical Skills Test must be repeated' (rule 64B9-15.008(1)) — so a candidate who passes one half and stalls loses both. A fourth kind of ending is disciplinary rather than administrative and is governed by Fla. Stat. 464.204 (denial, suspension or revocation) and the Board's disciplinary guidelines in rule 64B9-15.009, effective January 1, 2026; those are outside the scope of this page.",
   "reciprocity": "Florida grants certification by endorsement under the mobile programme, and the test is practice history rather than an exam. Statutory hook: a person qualifies for a Florida CNA certificate who 'Has been deemed by the board as eligible for licensure by endorsement under s. 456.0145' (Fla. Stat. 464.203(1)(c)); rule 64B9-15.0035 (effective January 12, 2026) requires the applicant to 'submit as part of his or her application DH-MQA-5102 (Revised 8/2025), Board of Nursing Mobile Opportunity by Interstate Licensure Endorsement (MOBILE)' and to 'meet and comply with all requirements in Section 456.0145(2), F.S.' The Board publishes the conditions: hold 'an active, unencumbered license issued by another state, the District of Columbia, or a territory of the United States in a profession with a similar scope of practice'; have 'actively practiced the profession for at least two years during the four-year period immediately preceding the date of submission of this application'; never have been reported to the National Practitioner Data Bank (unless the report was successfully appealed or the conduct would not violate Florida law); not be the subject of a disciplinary proceeding in a jurisdiction where the applicant holds a license, or by the U.S. Department of Defense, related to the profession; not have had disciplinary action taken 'in the five years immediately preceding the date of application'; and complete a Level II background screening using ORI# EDOH0380Z. The applicant also asks the other state board to send license verification — 'If the state has an online verification including disciplinary actions, we will accept the online verification' — and applies online at flhealthsource.gov. Issuance is fast when the file is clean: 'the license will be issued to qualified within 7 days pursuant to Section 456.0145(2)(e), Florida Statutes.' A separate, much faster path to working exists in the meantime: a nursing facility may employ, for a single consecutive period of four months, a person 'who ha[s] been positively verified as actively certified and on the registry in another state with no findings of abuse, neglect, or exploitation in that state' (Fla. Stat. 400.211(2)(b)). And an out-of-state CNA whose certification has lapsed applies through Prometric's E5 Lapsed Nursing Assistant route instead. ⚠ Do not confuse any of this with the Nurse Licensure Compact: Florida joined the NLC on January 19, 2018, but the NLC covers RNs and LPNs, not CNAs; the compact material on the Board's CNA page concerns nurses.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Florida Board of Nursing — Certified Nursing Assistant (CNA). The program's home page, carrying both the Examination and mobile Endorsement tabs. Establishes the three alternative examination routes (approved program, high school diploma or equivalent, or age 18) with the Level II screening using ORI# EDOH0380Z; the House Bill 975 (2024) electronic-fingerprinting requirement; the six-month skills-test waiver; the three-attempt bar; that applications go to Prometric and the Board reviews within 30 days; the exam structure ('a ninety (90) minute test with sixty (60) multiple-choice questions', oral or Spanish on request, 'five (5) randomly selected nursing assistant skills'); the 24-hour biennial in-service requirement and its subject list; that 'All fees are paid directly to Prometric and the Livescan service provider'; the mobile endorsement conditions and the seven-day issuance; and the criminal, health and disciplinary history documentation rules.\", \"url\": \"https://floridasnursing.gov/licensing/certified-nursing-assistant/\"}, {\"label\": \"Fla. Stat. 464.203 (official text, The Florida Senate, 2025 Florida Statutes). Establishes the read-and-write minimum, the four certification routes, the 6-month skills-test waiver, 'If an applicant fails to pass the nursing assistant competency examination in three attempts, the applicant is not eligible for reexamination unless the applicant completes an approved training program', the oral-exam substitute, the 24-consecutive-month non-practice rule and its retraining-or-retesting consequence, the address duty, the 24-hour biennial inservice requirement, and the '$20 and not more than $50 biennially' renewal fee range.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.203\"}, {\"label\": \"Fla. Stat. 464.201 (official text). Establishes the definitions of 'approved training program', 'certified nursing assistant' ('a person who meets the qualifications specified in this part and who is certified by the board'), 'registry' ('the listing of certified nursing assistants maintained by the board'), and the full statutory scope of the 'Practice of a certified nursing assistant'.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.201\"}, {\"label\": \"Fla. Stat. 464.202 (official text). Establishes the Board's duty to maintain or contract out the registry, the required registry contents and its public accessibility, the Board's rulemaking over testing procedures and scope of practice, and the authority to contract for examination services including the duties to offer internet applications and to 'provide the preliminary results of the certified nursing examination on the date the test is administered'.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.202\"}, {\"label\": \"Fla. Stat. 464.2035 (official text). Establishes CNA medication administration by RN delegation, the routes of administration permitted in a nursing home versus a home health agency or county detention facility, the initial 6-hour board-approved training course and competency finding, and the annual '2 hours of inservice training in medication administration and medication error prevention' that is 'in addition to the other annual inservice training hours'.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.2035\"}, {\"label\": \"Fla. Stat. 400.211 (official text). Establishes where certification is actually required — 'To serve as a nursing assistant in any nursing home, a person must be certified' — the licensed-nurse exclusion, the four categories employable uncertified 'for a single consecutive period of 4 months' and the four-month deadline, the employer's employment-history verification duty, the 12-month performance review and its minimum inservice content, and the Qualified Medication Aide designation with its 1-year certification prerequisite and 34-hour course.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/400.211\"}, {\"label\": \"Fla. Stat. 464.207 (official text). Establishes that failing to disclose a material fact by false statement, misrepresentation, impersonation or other fraudulent means in a certification or employment application under part II is a first-degree misdemeanour.\", \"url\": \"https://www.flsenate.gov/Laws/Statutes/2025/464.207\"}, {\"label\": \"Fla. Admin. Code ch. 64B9-15 chapter index (flrules.org, the official Florida Administrative Code site run by the Department of State). Establishes the full rule list with each rule's current effective date, including the repeal of 64B9-15.003 on 11/1/2015 and the 1/12/2026 and 1/1/2026 effective dates on the endorsement and disciplinary rules.\", \"url\": \"https://www.flrules.org/gateway/ChapterHome.asp?Chapter=64B9-15\"}, {\"label\": \"Fla. Admin. Code r. 64B9-15.006, Standardized Curriculum (official rule text). Establishes 'The standardized curriculum shall require a minimum of 80 hours of classroom and 40 hours clinical instruction. The clinical instruction shall include at least 20 hours of long term care clinical instruction in a licensed nursing home', the expired 2021-2022 clinical-simulation allowance, the 16 pre-contact classroom hours and their five subject areas, and the direct-supervision requirement.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.006\"}, {\"label\": \"Fla. Admin. Code r. 64B9-15.008, Testing and Competency Evaluation (official rule text). Establishes the two-part examination and the two-year validity window, the written content areas, 'the Board adopts a passing minimum score on the base from of 76%', the clinical skills structure ('three of the following tasks in addition to hand washing and indirect care') and full task list, the standard-error-based skills passing level and the need to pass all five tasks, the three-attempt bar, and the Clinical Skills Observer qualifications.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.008\"}, {\"label\": \"Fla. Admin. Code r. 64B9-15.011, In-Service Training Requirements (official rule text). Establishes the 24 hours per biennium, the 1.0-hour-per-month proration, the seven required subject areas, the college-coursework substitution, the active-duty and military-spouse exemptions, and the four-year retention and audit duty.\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.011\"}, {\"label\": \"Fla. Admin. Code r. 64B9-15.0045, Certified Nursing Assistant Renewal Fee (official rule text). Establishes '(1) For renewal of Certified Nursing Assistant Certificate... the fee is $50.00. (2) The fee for change in status on a delinquent license... is $50.00.'\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.0045\"}, {\"label\": \"Fla. Admin. Code r. 64B9-15.0035, Certification by Endorsement (official rule text, effective 1/12/2026). Establishes the mobile application form DH-MQA-5102 (Revised 8/2025) and the requirement to meet all of Fla. Stat. 456.0145(2).\", \"url\": \"https://www.flrules.org/gateway/RuleNo.asp?id=64B9-15.0035\"}, {\"label\": \"Prometric — Florida Nurse Aide Exam program page, the state's contracted test administrator, linked by the Florida Board of Nursing. Establishes 'The Florida Department of Health (DOH) has contracted with Prometric to develop and administer its Certified Nursing Assistant (CNA) Exam', the full application-process chain and its timings ('at least 50 days before the requested test date'; Board review 'can take up to 30 days'), the online and paper applications, the test-site list, and the link back to the state registry for verification.\", \"url\": \"https://www.prometric.com/exams/nurseaide-fl\"}, {\"label\": \"Florida Certified Nursing Assistant Candidate Information Bulletin (Prometric, rev. 11/01/2025). Establishes the five certification routes E1-E5 including the Challenger route and 'Lapsed Nursing Assistant'; the fee table (Clinical Skills and Written $155, Written $35, Clinical Skills $120, Rescheduling $30, Exam Review $25) and the conflicting $25 reschedule/no-show figure on the application form; 'Testing fees are nonrefundable and nontransferable' (the bulletin narrative's payment-section wording; the bound-in application form says 'Fees are non-refundable and non-transferrable'); 'If a nursing home employs you within 12 months of getting your certification, the facility is required to pay for your training and testing fees under federal law'; the written-test outline ('60 questions—90 minute time limit') with content weights; the ESL and ADA accommodation rules; the written test review process and its 21-day and 60-day deadlines; 'If you fail one portion of the test three times, you will have to do a state-approved training program that is at least 120 hours long'; the practice-exam prices; and the renewal and delinquency description ('Certificates that are not renewed before they expire will be considered delinquent. You may not work with a delinquent certificate') plus the '$25 fee to receive a new certificate showing your name change'.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/FL-CNA-CIB.pdf\"}, {\"label\": \"Florida Department of Health, Division of Medical Quality Assurance — License Verification search (the public lookup covering Certified Nursing Assistant under the Board of Nursing).\", \"url\": \"https://mqa-internet.doh.state.fl.us/MQASearchServices/HealthCareProviders\"}]",
   "page_url": "https://licensingatlas.com/cna/fl-cna/"
  },
  {
   "page_id": "ga-cna",
   "state": "Georgia",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Georgia Department of Community Health (DCH), Division of Medical Assistance Plans — the Georgia Nurse Aide Registry, administered day to day by Alliant Health Solutions under contract. The Department's own manual sets out the split: 'DCH has established and maintains a registry of nurse aides... The Contractor is contracted by DCH to oversee the daily operation and maintenance of the registry, while DCH maintains accountability for overall operation of the registry.' Adverse findings sit with a third body — DCH's Healthcare Facilities Regulation Division (HFRD), 'A State Department that investigates and maintains the Nurse Aide Adverse Finding information', and 'Only the State Survey and Certification Agency may place on the registry findings of abuse, neglect or misappropriation of property.' The written/oral and skills examination is delivered by an outside testing agency, currently Credentia. No board of nursing is involved.",
   "board_url": "https://dch.georgia.gov/divisionsoffices/hfrd",
   "application_url": "https://credentia.com/test-takers/ga",
   "renewal_cycle": "Every two years, and Georgia is one of the few registry states that runs it as a real renewal with a real expiry date. 'The nurse aide must renew their certification every two (2) years from date of original certification. The registry will send out renewal forms sixty (60) business days prior to expiration date. It is the responsibility of the nurse aide to renew their certification and to make sure the registry has the correct mailing address.' What renewal proves is work, not study: 'To be eligible for renewal based on employment, you must work for pay, performing nursing-related services, for at least eight (8) hours every twenty-four (24) consecutive months under the supervision of a nurse. This employment must be documented by completing an online Georgia Nurse Aide Registry renewal form and uploading the required documents prior to each listing expiration date. The listing expiration date is twenty-four (24) months from either the date of your last successful competency examination or last recertification date, whichever is more recent.' Proof: 'Proof of employment consists of a copy of a pay stub or W-2 form within the past twenty-four (24) consecutive months.' Private duty is allowed but costs more paperwork: an aide working private duty 'must be under the general supervision of an LPN or RN and provide a notarized letter from employer with the LPN or RN name and license number detailing job duties, length of employment, and state payment was given for services rendered within the past twenty-four (24) consecutive months.' Reminders are courtesy, not protection: a renewal reminder email goes out roughly 60 days before expiry, and 'It is your responsibility to renew by the expiration date, even if you do not receive the Renewal Reminder notification.' Address and name changes are a ten-day duty: 'If there is a change of address, it is the sole responsibility of the CNA to report this change. The CNA has ten (10) business days to report the change', with name changes requiring official documentation — a signed Social Security card in the new name plus government photo identification, or a court-issued marriage certificate, divorce decree or other legal document plus photo identification. 'Failure to inform the Registry of a physical address, email address or name change may jeopardize your listing status.'",
   "ce_hours": "None is required of the individual CNA to renew a Georgia registry listing. Renewal is proved by paid work and documentation, not by coursework — see the renewal details on this page, and note that the Department's renewal instructions ask only for a pay stub, a W-2 or (for private duty) a notarised employer letter. What does exist is a facility-side in-service duty, and Georgia states it with arithmetic: 'Full time CNAs status works 2080 hour/annually = 12 hours in-service. Part time CNAs at 20 hours a week = 1040 hours/annually = 6 hours of in service, etc.', with 'Part time and PRN CNAs also need to have in-service hours.' The obligation runs to the nursing home, not to the registry: 'The Nursing Home Facility must provide such regular performance review and regular in-service education to assure that individuals used as nurse aides are competent to perform services as nurse aides, including training for individuals providing nursing-related services to residents with cognitive impairments. The facility must complete a performance review of every nurse aide at least once every twelve (12) months.' So a Georgia CNA in a nursing home should receive in-service hours proportional to hours worked, but missing them is a facility compliance problem rather than a bar to renewing the registry listing. Sources checked: the Department's Nurse Aide Training Program Manual (Part II, version dated July 1, 2026) in full, the state contractor's Certified Nurse Aide pages, and the state-approved Georgia Nurse Aide Candidate Handbook articles on eligibility, the registry, exam fees and exam results.",
   "exam": "Two parts, both required: 'There are two parts of the NNAAP Examination, the Written (or Oral) Examination and the Skills Evaluation. You must pass both parts to be listed on the Georgia Nurse Aide Registry.' Written: 'seventy (70) multiple-choice questions written in English.' Oral, for candidates who have difficulty reading English: 'sixty (60) multiple-choice questions and ten (10) reading comprehension/word recognition questions', and it must be requested at registration. A Spanish form also exists — the Georgia fee table prices a 'Spanish Examination Only' at the same rate as the written and oral forms. Skills: 'you will be asked to perform five (5) randomly selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator', and the standard is all-or-nothing: 'You need a Satisfactory result on all five (5) skills to pass the Skills Evaluation.' Results: delivered online within a few hours of the testing day, 'listed as Pass or Fail only, there is no numeric score included'; 'Test results will not be given over the telephone, nor can they be sent by Credentia to your employer.' A failing skills report is diagnostic — it names each of the five skills, marks each Satisfactory or Unsatisfactory, and prints the step numbers missed under any failed skill. Attempts and clock: three attempts within twelve months of programme completion for the ordinary route, after which retraining is required; and three failures of either part means retaking both parts after a new training programme. Eligibility routes change the clock, and Georgia publishes seven of them: E1 new nurse aide (Georgia-approved programme); E2 currently licensed LPN/RN; E3 out-of-state-trained but not yet on any registry; E4 out-of-state-trained with a lapsed certification of a year or less; E5 Georgia certification lapsed a year or less; E6 reciprocity candidates who are active elsewhere but have not worked in 24 months, or who are listed as not eligible to work in long-term care, or who hold a Maryland CNA rather than a GNA; and E7 candidates whose Georgia-approved training institute is no longer active. Routes E2 through E6 require authorisation from the registry contractor before the candidate may apply to test. ⚠ The vendor's handbook states the E4, E5 and E7 windows two different ways in two different articles. After passing: results are transmitted electronically and 'The Georgia Nurse Aide Registry will have ten (10) business days to place the certified nurse aide's information on the registry.'",
   "fees": "Georgia charges nothing to be listed, and says so in a way that also binds the schools: 'DCH does not impose any charges related to registration for individuals to be listed on the registry; therefore, programs may not request or require payment related to registration of an individual.' There is also no renewal fee: 'There is no renewal fee for re-listing on the Georgia Nurse Aide Registry certification', and no charge for a name or address change — 'There is no charge for changing your name or address on the Registry.' The costs are examination fees, set for Georgia by the Department's testing agency: Written Examination Only $35; Oral Examination Only $35; Spanish Examination Only $35; Skills Examination Only $95; Competency Evaluation (Written and Skills) $130; Competency Evaluation (Oral and Skills) $130. Payment goes through the candidate's testing account 'in the form of a credit card, debit card, single-use card, or electronic voucher. Vouchers can be purchased by the training programs.' Who should be paying: 'Under federal and Georgia laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test.' Not set by the state: training tuition, which each approved programme sets — though Georgia protects the student's paperwork from a fee dispute: 'Training program completion certificates cannot be held for funds owed.'",
   "legal_basis": "[{\"citation\": \"42 CFR Part 483, Subpart D — nurse aide training and competency evaluation programs, competency evaluation, and the state nurse aide registry (including the supervised-practical-training definition and the 24-consecutive-month retraining rule the Georgia manual reproduces)\", \"what_it_governs\": \"The federal frame Georgia's programme implements and quotes throughout: the required curriculum areas, the 16 hours of instruction before direct resident contact, the definition of supervised practical training as 'training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse', the registry-removal rule after 24 consecutive months without nursing-related services, and the facility's duty to provide a competency evaluation programme and annual performance review with in-service education.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"Social Security Act §§ 1819(g) and 1919(g) — petition for removal of a finding of neglect from a nurse aide registry\", \"what_it_governs\": \"The single narrow route by which a revoked Georgia certification can be restored. The Department quotes the standard: a petition may succeed where 'the employment and personal history of the nurse aide does not reflect a pattern of abusive behaviors or neglect; and the neglect involved in the finding was a singular occurrence', and 'a determination on a petition for removal cannot be made prior to the expiration of a one-year period beginning on the date which the finding against the nurse aide was added to the Nurse Aide Registry.' Note: the state-approved handbook renders the first citation as 'The Social Security Act 1319(g) (1) (D)'; section 1319 does not govern nurse aide registries and 1819(g) does. The typographical error is recorded rather than reproduced.\", \"url\": \"https://kb-ga.credentia.com/en/article/the-registry\"}, {\"citation\": \"Georgia Department of Community Health, Division of Medical Assistance Plans — Policies and Procedures for Nurse Aide Training Program Manual, Part II, version dated July 1, 2026\", \"what_it_governs\": \"Georgia's operative rulebook for this credential: conditions of programme approval and re-approval, the 85-hour and 24-clinical-hour minimums, the 16-hour pre-contact gate, the English-only course rule, the eight-hour daily cap and the overnight clinical bar, conditions of student certification, the competency evaluation and its three-attempts-in-twelve-months limit, the registry and adverse findings, the 24-consecutive-month removal and retraining rules, two-year certification renewal, registry access, reciprocity requirements, and the rule that DCH imposes no registration charge and programmes may not charge for registration.\", \"url\": \"https://nurseaide.allianthealth.org/GetFile?f=help/Nurse%20Aide%20Training%20Program-Q3-2026.pdf\"}, {\"citation\": \"Rules of the Georgia Department of Community Health, Chapter 111-8 (Healthcare Facility Regulation) — the nursing home and healthcare facility rules under which HFRD investigates and records nurse aide adverse findings\", \"what_it_governs\": \"The facility-regulation side of the scheme, including the survey-agency role the Department describes as 'Only the State Survey and Certification Agency may place on the registry findings of abuse, neglect or misappropriation of property.' The rule text was not read — Georgia's administrative-rules website refused our request on 2026-08-14 — so no specific rule number or wording is quoted, and this entry names the authority rather than sourcing a fact to it.\", \"url\": \"https://dch.georgia.gov/divisionsoffices/hfrd/hfrd-laws-regulations\"}]",
   "exam_vendor": "Credentia, delivering the National Nurse Aide Assessment Program (NNAAP) through the CNA365 system. The Department of Community Health names it in its manual — 'The Georgia Nurse Aide Program has an outside testing agency to administer the written/oral and skills competency examination' and 'Introduction of the testing agency – currently utilizing Credentia' — and directs candidates to create an account at credentia.com/test-takers/ga. The registry's own public page dates the arrangement: 'A third-party test vendor has administered the Georgia Written/Oral and Skills examination since July 1, 2007.' The Department keeps scoring away from the schools: where a facility or programme proctors, the evaluation must be 'standardized and scored by a testing, educational, or other organization approved by the State' and 'Requires no scoring by facility or program personnel', and DCH 'must and will retract the right to proctor Nurse Aide Competency Evaluations from facility based or non-facility-based programs in which DCH finds any evidence of impropriety.' ⚠ The vendor's Georgia handbook misnames the state agency, saying it was created 'in partnership with the Georgia Department of Health' — Georgia has no agency by that name in this scheme; the registry belongs to the Department of Community Health.",
   "training_hours": "85 hours minimum, of which 24 must be clinical rotation — ten hours above the federal floor. The Department of Community Health states it twice in its own manual: 'Georgia requires a minimum of eighty-five (85) hours of training which must include twenty-four (24) hours of clinical rotation in a facility supervised by an approved Registered Nurse or Licensed Practical Nurse', and again in the curriculum chapter, 'the program must have at a minimum, an eighty-five (85) hour training curriculum. The eighty-five (85) hours of program includes classroom/lab hours and a mandatory twenty-four (24) hours of clinical training within an approved healthcare facility clinical setting.' The registry's own public search page carries the same figure for readers: 'The Georgia Nurse Aide Program requires a minimum of 85 hours, which includes classroom, lab and clinical rotation, for all approved nurse aide training program courses in the State of Georgia.' Four constraints sit inside the 85. (1) The 16-hour gate: 'The first sixteen (16) hours of training must include these subjects. The training must be completed before the student has any direct contact with a facility resident' — communication and interpersonal skills including stress management and chain of command, infection control, safety and emergency procedures including foreign-body airway obstruction and body mechanics, promoting residents' independence, and respecting residents' rights. (2) Core curriculum only: 'The 85 hours required by the state must be spent on the Federal/State Core Curriculum. All additional subject matter hours must be added to the required hours.' (3) Orientation excluded: 'Orientation to the facility cannot be included in the twenty-four (24) hours of clinical.' (4) A daily cap and a time-of-day bar: 'A maximum of eight (8) hours is allowed for the training of the NA student per day', and clinical may not run 10 p.m. to 7 a.m. ⚠ One internal tension, recorded both ways: the same manual, quoting the federal standard, says 'The Code of Federal Regulations requires that each nurse aide program provide at least sixteen (16) hours of supervised practical training', while its curriculum section requires programmes to 'Include at least twenty-four (24) hours of supervised practical training' using the identical definition of that term. Georgia's operative requirement is the higher figure — 24 hours of clinical — and the 16-hour sentence describes the federal minimum it exceeds. Georgia is not a nursing-home-only trainer: 'Georgia requires the program to provide one comprehensive course to train candidates to work in all health care facilities (e.g. nursing homes, hospitals, hospice, home health, etc.).'",
   "lapse_rule": "The trigger is twenty-four consecutive months without at least eight hours of paid nursing aide work, and Georgia's registry actually removes the entry: 'The registry must remove entries for individuals who have performed no nursing-related services for a period of twenty-four (24) consecutive months, unless the individual's registry entry includes documented findings of abuse, neglect or misappropriation of property.' The retraining rule follows: 'If, since an individual's most recent completion of a training and competency evaluation program, there has been a continuous period of twenty-four (24) consecutive months during none of which the individual performed at least eight (8) hours of nursing aide services for monetary compensation, such individual shall complete a new training and competency evaluation program or a new competency evaluation program to qualify for employment.' How far past expiry matters — and the Department says it two ways in one paragraph, so both are recorded: 'If an individual's nurse aide certification has expired over twenty-four (24) months from the last recertification date, the individual must complete a new training and competency evaluation program. If the nurse aide certification has expired one year or more from the registry expiration date, the individual must complete a new state approved training program; after successfully passing both parts of the competency exam, the individual's certification is updated for two (2) years.' (That second sentence is marked in the manual as a revision dated August 2025.) The shorter lapse has its own testing route: a candidate 'whose Georgia certification has lapsed or expired... inactive or expired (lapsed) for one (1) year or less' may test under eligibility route E5 after obtaining authorisation from the registry contractor, with three attempts. Adverse findings are a different and heavier matter: 'Adverse findings remain in the CNA record indefinitely unless the individual was found not guilty in a court of law, or the state is notified of the individual's death.' One narrow door exists, and only for neglect: a person whose certification was revoked for a finding of neglect 'may petition the state to have his or her name removed from the registry' where 'the employment and personal history of the nurse aide does not reflect a pattern of abusive behaviors or neglect; and the neglect involved in the finding was a singular occurrence', and no determination may be made before one year has passed since the finding was added. Petitions go to the C.N.A. Abuse Registrar at DCH's Healthcare Facility Regulation Division in Atlanta.",
   "reciprocity": "Georgia calls it a transfer and runs it on a form, with conditions that catch people out. 'Nurse aides transferring from another State's nurse aide registry must complete a transfer form', obtained from the registry web portal under the Nurse Aide/Medication Aide tab or from the registry directly. The two conditions: 'The certified nurse aide must be current, in good standing on the other state's registry and have proof of employment within the past twenty-four (24) consecutive months.' A third condition most summaries miss, aimed at people who trained elsewhere and never finished testing: 'If the nurse aide does not complete and pass the written/oral and skills competency exam within one (1) year of completion in another state's approved training program, Georgia will not extend reciprocity. The nurse aide must complete a Georgia State approved program and pass Georgia's written/oral and skills competency exam to become certified.' And a discretion the reader should plan around: 'The State Contractor reserves the right to require nurse aides transferring to take the written/oral and skills competency exam' — so an incoming transfer is not guaranteed to be exam-free. Some incoming candidates are routed to the examination outright: eligibility route E6 covers people 'active and in good standing on another state's registry, but who have not worked as a nurse aide in the past two (2) years (24 months), listed in the other state as not eligible to work in a Long Term Care facility or a Maryland CNA instead of GNA', and they test with three attempts after the contractor authorises them. Out-of-state-trained candidates who are not on any registry use route E3, and those with a foreign lapse of a year or less use route E4. Nurses get no shortcut: 'A LPN or RN with an active nursing license in Georgia or another state within the U.S. will be required to take the written/oral and skills competency exams.' Timing: 'All requests for transfer or placement on the registry will be reviewed within ten (10) business days of receipt. The individual will receive written confirmation from the Contractor of placement or requirements needed for placement on the registry.' No transfer fee is published in any Georgia source we checked, and the Department's own charging rule points the other way: 'DCH does not impose any charges related to registration for individuals to be listed on the registry.' The public registry search returns a 'Reciprocity State' column, so a transferred listing is visibly marked as such.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Georgia Department of Community Health, Division of Medical Assistance Plans — 'PART II POLICIES AND PROCEDURES for NURSE AIDE TRAINING PROGRAM MANUAL', version dated July 1, 2026 (PDF, 48 pages), published on the state's Nurse Aide Program portal. The single richest source on this page. Establishes the 85-hour minimum and 24 clinical hours, 'The nurse aide course must be taught in English ONLY', the core-curriculum-only rule, the exclusion of orientation from clinical hours, the acceptable clinical settings and the exclusion of personal care homes and senior care retirement communities, the eight-hour daily cap and the 10 p.m.–7 a.m. clinical bar, the 16-hour pre-contact subject list, the conditions of student certification, the three-opportunities-in-twelve-months rule and the retraining consequence, the 80% programme pass-rate requirement and probation, 'Training program completion certificates cannot be held for funds owed', the registry's establishment and contractor management, adverse findings and their indefinite retention, the 24-consecutive-month removal and retraining rules with the pay-stub/W-2 and notarised private-duty proof requirements, two-year renewal with 60-business-day notice, registry access by phone and web, the reciprocity conditions and the contractor's right to require testing, the LPN/RN examination requirement and the awaiting-licensure route, and 'DCH does not impose any charges related to registration.' Its revision log also records that all references to www.mmis.georgia.gov were removed and replaced with careconnect.georgia.gov on 02/23/2026.\", \"url\": \"https://nurseaide.allianthealth.org/GetFile?f=help/Nurse%20Aide%20Training%20Program-Q3-2026.pdf\"}, {\"label\": \"Georgia Nurse Aide Program — Search for a Certified Nurse Aide (the Department's designated public registry lookup, run by Alliant Health Solutions and linked from DCH's Healthcare Facility Regulation Division page). Establishes the search fields and status filter, the post-result SSN and date-of-birth validation step, the result columns including expiration date, adverse findings and reciprocity state, and the statements that 'The Georgia Nurse Aide Program requires a minimum of 85 hours, which includes classroom, lab and clinical rotation' and 'A third-party test vendor has administered the Georgia Written/Oral and Skills examination since July 1, 2007.'\", \"url\": \"https://nurseaide.allianthealth.org/NurseAide/SearchCNA\"}, {\"label\": \"Georgia Nurse Aide Program — Certified Nurse Aide section of the state's registry portal (Alliant Health Solutions for DCH), carrying the CNA, Certified Medication Aide, Nurse Aide Training Program and Nursing Home Staff Development Facilities sections, the online submission forms and the Nurse Aide Adverse Findings Report.\", \"url\": \"https://nurseaide.allianthealth.org/PageLinks?g=CNA\"}, {\"label\": \"Georgia Nurse Aide Program — Manuals page, which publishes the Nurse Aide Program Manual together with the UGA Virtual Skills Evaluation facility and candidate manuals, the DCH nursing home rules for CMAs, and the blended-learning theory training requirements for LMS platforms.\", \"url\": \"https://nurseaide.allianthealth.org/PageLinks?g=Manuals\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — Eligibility Criteria. Establishes that all candidates apply for registration by competency examination online, the light-duty bar on the skills evaluation, and the seven eligibility routes E1 to E7 with their attempt limits and the requirement to contact Alliant Health Solutions for authorisation on routes E2 to E6.\", \"url\": \"https://kb-ga.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — Exam Overview. Establishes the two-part structure, the 70-question written examination, the 60-plus-10 oral alternative and the requirement to request it at registration, and the five randomly selected skills rated by a Nurse Evaluator.\", \"url\": \"https://kb-ga.credentia.com/en/article/exam-overview\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — Exam Fee. Establishes the Georgia fee table ($35 written only, $35 oral only, $35 Spanish only, $95 skills only, $130 written and skills, $130 oral and skills), the accepted payment methods including training-programme vouchers, and 'Under federal and Georgia laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test.'\", \"url\": \"https://kb-ga.credentia.com/en/article/exam-fee\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — Exam Results. Establishes Pass/Fail-only score reporting with no numeric score, the online-only delivery and refusal to give results by telephone or to employers, the all-five-skills-Satisfactory pass standard, the diagnostic failing skills report, the three-failures-means-retake-both-parts rule, the absence-counts-as-an-attempt rule, and the per-route timeframes.\", \"url\": \"https://kb-ga.credentia.com/en/article/exam-results\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — The Registry. Establishes the ten-business-day name/address change duty and its documentation requirements, 'There is no charge for changing your name or address on the Registry', the two-year listing renewal and the eight-hours-in-24-months work requirement, the listing expiration date rule, the 60-day renewal reminder and the responsibility to renew regardless, 'There is no renewal fee for re-listing', and the Social Security Act petition route for removal of a neglect finding with the DCH/HFRD petition address.\", \"url\": \"https://kb-ga.credentia.com/en/article/the-registry\"}, {\"label\": \"Georgia Nurse Aide Candidate Handbook (Credentia) — Quick Reference. Establishes the contact split between Credentia (registration, scheduling, score reports, grievances) and Alliant Health Solutions ('Call for an application for eligibility routes E2, E3, E4, E5 or E6'), with the registry's CareConnect address and telephone numbers.\", \"url\": \"https://kb-ga.credentia.com/en/article/quick-reference\"}, {\"label\": \"Georgia Department of Community Health — Healthcare Facility Regulation Division. The state-host page from which DCH links the certified nurse aide search. Carries two 'Find a Certified Nurse Aide' links, one working and one pointing at the retired GAMMIS proxy.\", \"url\": \"https://dch.georgia.gov/divisionsoffices/hfrd\"}]",
   "page_url": "https://licensingatlas.com/cna/ga-cna/"
  },
  {
   "page_id": "hi-cna",
   "state": "Hawaii",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Hawaii Department of Commerce and Consumer Affairs (DCCA) — Professional and Vocational Licensing Division, Nurse Aide Program (certification and registry), with the Department of Human Services Med-QUEST Division responsible for training programs and recertification standards and the Department of Health responsible for discipline in health-department-licensed settings",
   "board_url": "https://cca.hawaii.gov/pvl/programs/nurse/",
   "application_url": "https://www.prometric.com/nurseaide/hi",
   "renewal_cycle": "Every two years, and the requirements split by where the aide works. The frame: 'A nurse aide's certification is valid for a limited period up to twenty-four months and shall be renewed biennially. The certification of each nurse aide shall cease upon the expiration of that nurse aide's current biennial certification period, as determined by the department' (HAR 16-89A-4(a)). The filing deadline is a month early and the burden is entirely the aide's: 'A nurse aide's recertification application shall be received by the department on or before the end of the business day that is one month before the date the current certification expires... Lack of notification by the department shall not be a valid reason for a nurse aide's non-renewal.' A reminder is sent as a courtesy — 'A renewal reminder notice will be mailed to you approximately 90 days before the expiration of your certificate' to the address on the registry — which is why the rules make address updates the aide's job. Medicare or Medicaid nursing facility track (the contractor's Group 1), from HAR 16-89A-4(b): '(1) An annual performance review completed by the facility at least once every twelve months; (2) Regular in-service training provided by that facility based upon the outcome of the annual performance reviews; (3) A completed renewal application on a form approved by the department and postmarked or received by the department on or prior to thirty (30) days before the biennial expiration date... signed by the medicare or medicaid certified nursing facility's director of nurses, registered nurse, director of human services, physician or designee...; and (4) Verification that, for monetary compensation, the nurse aide provided, at a minimum, one full day of nursing or nursing-related services, in a medicare or medicaid certified nursing facility, involving direct patient care within the prior twenty-four months.' No fee. State-licensed or state-certified setting track (Group 2), from HAR 16-89A-4(c): '(1) A competency evaluation approved by the department of human services; (2) A completed renewal application, including applicable fees...; and (3) Verification acceptable to the department that, for monetary compensation, the nurse aide provided, at a minimum, one full day of nursing-related services, in a state-licensed or state-certified health care setting, involving direct patient care within the prior twenty-four months.' Plus the 24 continuing-education hours the human services department sets. Fee $27. The work test as the contractor states it, on the live recertification form: 'To renew your certification, you must have worked for pay performing nursing, nursing related services and/or direct patient care, under the supervision of a Licensed or registered nurse, for at least 8 hours during the last 24-month certification period', with the employer confirming on the form whether 'the nurse aide work for your facility/business for a minimum of 8 hours providing nurse aide duties for pay working under the supervision of a licensed, practical, or registered nurse'. Employer verification 'must be signed by a Hawaii licensed health professional responsible for the development of the plan of care'. Forms 'should not be submitted more than 30 days before your current certification expiration period', they 'must be mailed' and 'cannot be processed in person', and 'If you qualify for recertification, your new certification period will be for two years from expiration date.' Read together, the rule and the form leave almost no window: the rule requires the application to be received one month before the certification expires, while the contractor's form says not to submit it more than 30 days before expiry. Neither source reconciles the two.",
   "ce_hours": "24 hours per two-year period — but only on the state-licensed and state-certified settings track, and the number is a statutory ceiling as well as the requirement. The CAP: the director of human services implements the provisions relating to 'Training programs for nurse aides and recertification; provided that recertification shall be required not less than every two years and the number of continuing education hours required for recertification shall not exceed twenty-four hours, except as specified by federal law' (HRS 457A-2(c); the paragraph numbering the ceiling used to sit under was removed when the Legislature flattened the subsection, am L 2016, c 21, §3, and the ceiling itself survives unchanged). The requirement, from the Department of Human Services rules on recertification of nurse aides in state-licensed or state-certified health care settings (HAR 17-1445, effective July 12, 2013): the nurse aide must complete 'twenty-four hours of continuing education in the two year period prior to the expiration of the current nurse aide certification', on subjects relevant to nurse aide employment in such settings, which the rule says may include communication and interpersonal skills, universal precautions and infection control, safety and emergency procedures including the Heimlich maneuver, understanding and promoting client independence, respecting client rights, basic nursing skills including recognising abnormal changes in body functioning, personal care skills for maintaining elderly, disabled and cognitively impaired clients in home-like settings, mental health and social service needs and resources, basic restorative services, health care delivery systems in Hawaii with emphasis on agencies serving the aged and disabled, and best practices in caring for clients with diabetes, end-stage renal disease and cancer and clients who are terminally ill. On top of the hours, the aide must complete a competency evaluation signed by an approved registered nurse instructor or registered nurse evaluator on a department-approved form. Two ways to do it, which the rule calls Option A and Option B. Option A is a single 24-hour course of study delivered by a state-certified nurse aide training and competency evaluation program under a registered nurse instructor with at least two years of nursing experience, one of it in nursing facility services, who has completed a course in teaching adults or has experience teaching adults or supervising nurse aides; the instructor signs the competency evaluation and the program issues a certificate of completion. Option B is 24 hours of continuing education class instruction from providers such as community colleges, health-related agencies or organisations, or registered nurses working as independent contractors, with a certificate for each class identifying the title, the instructor and the number of instructional hours — and the aide is responsible for arranging an approved registered nurse evaluator to certify both the hours and a demonstrated competency in basic nurse aide skills. Instructors and evaluators report the completions onward: registered nurse instructors and registered nurse evaluators submit the names of aides who have met the requirements to the Department of Commerce and Consumer Affairs in the format that department prescribes (HAR 17-1445-6). The other track has no continuing-education hour count at all: a medicare or medicaid nurse aide renews on the facility's annual performance review plus 'Regular in-service training provided by that facility based upon the outcome of the annual performance reviews' (HAR 16-89A-4(b)(2)) — training that is required but not expressed as a number of hours in any Hawaii source we checked.",
   "exam": "Two parts and a published passing score — Hawaii is one of the few states that puts the number in its rules. HAR 16-89A-3(a)(2): certification requires 'The nurse aide examination approved by the director, with a passing score of seventy per cent on the test, along with the successful demonstration of certain skills. The examination shall consist of either a written or oral test, at the election of the applicant, along with a demonstration of skills by means of a skills evaluation. The skills demonstration shall consist of five randomly selected items drawn from a pool consisting of tasks generally performed by a nurse aide; the person must successfully demonstrate all of these skills. The pool of skills shall include all personal care skills listed in 42 Code of Federal Regulations (C.F.R.) 483.152(b)(3).' Note that the rule treats the written and oral versions as alternatives the candidate elects, not as an accommodation the state grants. Written test, as delivered: 'The Written test consists of 60 multiple-choice questions that evaluate your nurse aide knowledge and skills. You will have 90 minutes to take the test', weighted by a published outline — Role of the Nurse Aide 20%, Promotion of Safety 22%, Promotion of Function and Health of Residents 20%, among other domains. Oral form: candidates 'will be provided a headset', hear the questions read, and may replay any question; the choice is made on the application and 'This request cannot be made on the day of testing.' Clinical skills test: computer-assigned and timed, 'you will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care', where Indirect Care covers residents' rights and preferences, communication, safety, comfort and needs, and infection control. 'The time allowed for the Clinical Skills test ranges from 31 minutes to 40 minutes based on the skills you are asked to perform.' 'To pass the Clinical Skills test, you must pass all five skills.' Corrections may be made mid-skill if announced and performed, but not after the skill is finished and not where a safety issue arose. Candidates are asked to act as the resident for another candidate, and the bulletin lists the twelve skills that may be performed on a resident actor. Attempts and eligibility window — three attempts and two years, measured from the first test date, which is different from how most states measure it: 'You must pass your Competency Exam within two years of your first testing date and within three attempts. If you do not pass both parts of the exam within two years of your first testing date or within three attempts, you will be required to retrain and retest', and 'Candidates testing under Route 1 are eligible to test for two years after their first test date.' Unused fees do not carry over: 'If you fail to complete testing during your eligibility period, you will not be refunded any unused test fees, nor will test fees be carried over to a new eligibility period.' Language: 'The Hawaii Nurse Aide Competency Exam is offered only in English. Translators are not permitted, and translation dictionaries may not be used during the exam administration' — the oral form is offered as the alternative for candidates for whom English is a second language. Results: 'Your official score report(s) will be mailed to your address of record within 10 business days of your test date. Results are confidential and are not given out over the phone. If you pass both tests, your Hawaii Nurse Aide Certificate and wallet card will be mailed to you and your name will be added to the Hawaii Nurse Aide Registry.' Clinical skills results appear online within 48 to 72 hours, with item-level feedback on missed checkpoints; a failed written or oral test produces 'diagnostic information that provides feedback on your areas of strength and weakness.' A candidate who fails is told what went wrong: 'A person who is unsuccessful in attaining certification shall be advised of the areas in which the person is deficient' (HAR 16-89A-3(e)). Accommodations: documentation submitted with the application, thirty days' advance notice, 'There is no additional charge for these accommodations.' Appeals: submitted in writing within 60 days of the exam date, with a written response 'within 20 business days.'",
   "fees": "Hawaii's exam fees, and a separate one-time processing charge on top. From the Hawaii Nurse Aide Testing/Out of State/Reciprocity Application Form and the state-approved bulletin, which agree: 'Initial Application Processing Fee (one-time fee, nonrefundable) $25', and 'All candidates are required to pay the one time Initial Application Processing fee'; Clinical Skills test and Written test $216; Clinical Skills test and Oral Written test $216; Clinical Skills test alone (retest) $162; Written test alone (retest) $54; Oral Written test alone (retest) $54; Reciprocity Fee $27; Recertification Fee $27; Duplicate Score Report $15; Duplicate Certificate $15; Rescheduling Fee $25 where at least five full business days' notice is given. Inside five business days, or for a no-show or a late arrival, the whole exam fee is payable again: 'If you reschedule less than 5 business days before your scheduled test date, did not show up for their scheduled exam, or arrived late for a scheduled exam you will be required to pay the entire test fee to reschedule.' Payment is by money order, certified or cashier's check, MasterCard or Visa; 'Personal checks and cash are not accepted'; 'Fees are not refundable or transferable.' Who pays nothing to recertify: an aide whose qualifying work was in a medicare or medicaid approved nursing facility. The recertification form's instruction is explicit — 'If your work experience as a nurse aide occurred in a Medicaid/Medicare approved nursing facility and the employer completed section 2, mail completed form to Prometric. No recertification fee is required' — and it is the statute talking: 'No charge shall be imposed on medicare or medicaid certified nurse aides for the maintenance of the nurse aide registry' (HRS 457A-7(f)). An aide whose work was in a state-licensed or state-certified setting pays '$27.00', because 457A-8(c) permits fees on that track. There is no separate state application fee paid to DCCA — the statute lets the director 'require that fees for services be paid directly to the professional testing service' (457A-4), and every figure above is paid to the contractor. Optional practice material, required by nobody: the Nurse Aide Practice Exam 'contains 50 questions. The fee for each practice exam is $10.' Training cost is set by the state-certified program and is not published by DCCA or Med-QUEST. Address and name updates are free: 'There is no charge for updating your address with the Hawaii Nurse Aide Registry' and the same for a name change, though a replacement certificate showing the new name costs $15.",
   "legal_basis": "[{\"citation\": \"Haw. Rev. Stat. ch. 457A (Nurse Aides), sections 457A-1 through 457A-9\", \"what_it_governs\": \"The whole Hawaii nurse aide scheme: the legislative findings and the decision to certify aides in state-licensed settings as well as federally regulated ones (457A-1); the definitions of certified nurse aide, medicare or medicaid nurse aide, nurse aide, state-licensed or state-certified health care settings and substantiated finding (457A-1.5); the three-way division of implementation between the directors of commerce and consumer affairs, health, and human services, including the 24-hour ceiling on continuing education (457A-2); the commerce director's rulemaking power, duty to issue certificates and maintain the registry, and the limit on that director's disciplinary role (457A-3); authority to contract with a professional testing service and to have fees paid directly to it (457A-4); the fee power (457A-5); the title-protection provision covering the abbreviation 'C.N.A.' (457A-6); medicare or medicaid nurse aide certification, its reciprocity clause and its no-charge registry rule (457A-7); certification for state-licensed or state-certified health care settings, its fee power, reciprocity clause and competency-evaluation recertification (457A-8); and, added in 2025, automatic revocation of a certification or denial of an application to renew, restore or reinstate it on a conviction requiring registration as a sex offender, with the notice, ten-day hearing election, thirty-day hearing, conclusive-evidence rule, automatic cessation on a successful appeal, public-record order and outright bar on restoration where the offence involved a patient or client (457A-9, [L 2025, c 273, §16]). Use the Legislature's current text for this chapter. The copy the DCCA licensing division publishes is stamped 'Amended 0709' and is a July 2009 copy: it still carries the pre-2016 definition of state-licensed or state-certified health care settings, still splits 457A-2(c) into two paragraphs including a discipline function the Legislature has since deleted, and does not contain 457A-9 at all.\", \"url\": \"https://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0457A/\"}, {\"citation\": \"Haw. Admin. R. tit. 16, ch. 89A (Department of Commerce and Consumer Affairs — Nurse Aide), effective February 12, 2009\", \"what_it_governs\": \"The certification requirements for both tracks, including the seventy per cent passing score, the written-or-oral election and the five randomly selected skills drawn from a pool that must include the personal care skills in 42 C.F.R. 483.152(b)(3); reciprocity certification; issuance of the certificate; notice to unsuccessful applicants and hearing rights on denial (16-89A-3); the biennial recertification rules for both tracks, the one-month filing deadline, and the consequence of failing the work test (16-89A-4); the registry's contents, its confidentiality and disclosure rules, the ten-working-day reporting of substantiated findings, the routing of appeals to health or human services, and the power to contract registry operations to a non-state entity (16-89A-5); and removal of registry entries after 24 consecutive months without service, plus the narrow grounds for removing a substantiated finding (16-89A-6).\", \"url\": \"https://cca.hawaii.gov/wp-content/uploads/2026/02/har_89a-c1.pdf\"}, {\"citation\": \"Haw. Admin. R. tit. 17, ch. 1445 (Department of Human Services — Recertification of Nurse Aides in State-Licensed or State-Certified Health Care Settings), effective July 12, 2013\", \"what_it_governs\": \"The 24 continuing-education hours required in the two years before certification expiry for aides in state-licensed or state-certified settings, the list of acceptable subject areas, and the competency evaluation signed by an approved registered nurse instructor or registered nurse evaluator; Option A, a single 24-hour course of study through a state-certified nurse aide training and competency evaluation program; Option B, 24 hours of continuing education class instruction from community colleges, health-related agencies or independent registered nurses, with an approved registered nurse evaluator certifying the hours and the skills; the definitions of competency evaluation, continuing education hours, registered nurse evaluator and registered nurse instructor; the rule that such settings 'may or may not require recertification'; and the duty of instructors and evaluators to report completions to the Department of Commerce and Consumer Affairs.\", \"url\": \"https://humanservices.hawaii.gov/wp-content/uploads/2013/01/17-1445-CNA-Recertification.pdf\"}, {\"citation\": \"42 U.S.C. 1395i-3 and 1396r, and 42 C.F.R. 483.150(b), 483.152 and 483.152(b)(3), as applied by Hawaii\", \"what_it_governs\": \"The federal frame the whole chapter implements. Hawaii's findings section recites that 'the legislature recognizes that 42 United States Code sections 1395i-3 and 1396r require nurse aides working in nursing facilities participating in medicare and medicaid programs to be certified', and every implementation duty in 457A-2 and 457A-3 is expressed as being 'in accordance with' those sections. The skills pool for the competency evaluation 'shall include all personal care skills listed in 42 Code of Federal Regulations (C.F.R.) 483.152(b)(3)', and the registry covers aides 'deemed to have met the requirements pursuant to 42 C.F.R. 483.150(b)'. The federal texts themselves were not read as of August 16, 2026; they are cited here as Hawaii cites them.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"Haw. Rev. Stat. ch. 91 (Administrative Procedure)\", \"what_it_governs\": \"The notice and hearing rights available to a nurse aide whose application for certification is denied (HAR 16-89A-3(f)) and the contested case hearing available where an aide disagrees with a decision about correcting a registry entry (16-89A-5(d)). The chapter text itself was not read as of August 16, 2026.\", \"url\": \"https://cca.hawaii.gov/wp-content/uploads/2026/02/har_89a-c1.pdf\"}]",
   "exam_vendor": "Prometric, under contract to the Department of Commerce and Consumer Affairs. The state-approved bulletin states the scope: 'The Hawaii Department of Commerce and Consumer Affairs (DCCA) has contracted with Prometric to develop and administer its Nurse Aide Competency Exam and to manage the Nurse Aide (NA) Registry.' The statute authorises exactly that arrangement without naming a company — the director 'may contract with a professional testing service that is qualified to test the competency of nurse aides' and 'may require that fees for services be paid directly to the professional testing service' (HRS 457A-4) — and the rule authorises contracting out registry operations while the State 'retains accountability for oversight' (HAR 16-89A-5(f)). DCCA's own nurse aide page routes candidates accordingly: 'Contact Prometric at: www.prometric.com/nurseaide/hi to: Download an application for an exam or reciprocity. Obtain exam information, Candidate Information Bulletin. Verify a nurse aide certification.' The contractor runs a Hawaii office at 354 Uluniu Street, Suite 308, Kailua, HI 96734.",
   "training_hours": "100 clock hours minimum, split 30/70 the opposite way from most states — the majority of the hours are supervised practical training, not classroom. The figures come from the Department of Human Services Med-QUEST Division, which is the agency Hawaii assigns to training: 'Under Federal regulation, the Medicaid Agency is the agency within the State that establishes the curriculum requirements for State certification of Nurse Aide Training Programs (NATPs) and determines the contents of the Competency Evaluation Program.' Its published Minimum Curriculum for a State Certified NATP reads: 'A minimum of 100 clock hours of training.' Classroom: 'Thirty (30) hours or more must be spent in classroom activities of which at least sixteen (16) hours of training must be in the following areas PRIOR to any direct contact with residents (patients): 1. Communication and interpersonal skills; 2. Infection control; 3. Safety/emergency procedures, including the Heimlich maneuver; 4. Understanding and promoting residents' (patients') rights; and 5. Respecting residents' (patients') rights.' The remaining classroom time must cover the Hawaii health care delivery system 'with special emphasis on agencies and facilities that care for the aged', conduct, language and dress, preventive health care, basic body functions, basic medical terminology, and care of the aged and special-needs population including mental health and social service needs, care of cognitively impaired residents and residents' rights. Practical: 'A minimum of seventy (70) hours must be in a supervised practical training', defined as 'training in a laboratory or other setting which the trainee learns and demonstrates knowledge and proficiency while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse (only for tasks specified by the Medicaid Agency).' Those 70 hours carry their own sub-minimums: 'Basic nursing skills—30 hours minimum; Basic personal care skills—30 hours minimum; and Basic restorative services—10 hours minimum', with basic nursing skills required to be 'taught and directly supervised by a registered nurse', basic personal care skills permitted to be taught by a licensed practical nurse under registered-nurse supervision, and basic restorative services permitted to be taught by 'a licensed or certified therapist working under the supervision of a registered nurse or by a registered nurse.' A completion gate applies at the end: 'The NATP must ensure the trainee does not complete the program before achieving competence in all areas of the supervised practical training.' Hawaii therefore sits 25 hours above the federal 75-hour floor, and its 70-hour clinical minimum is more than four times the federal 16-hour practical minimum. The document's vintage is worth knowing: the Med-QUEST page publishing these requirements is current, but the requirements document itself is dated May 11, 2004 and carries the signatures of that era's administration; no more recent version is published on the Med-QUEST certification-programs page.",
   "lapse_rule": "Hawaii ends a certification for not working, and the registry entry disappears on the same 24-month clock. The trigger, in the contractor's plain words: 'A nurse aide certification has expired and is invalid if the nurse aide has not worked for pay as a nurse aide for a minimum of eight hours during her/his most recent certification period.' The rule behind it: 'If a nurse aide has not provided proof of completing a minimum one full day of nursing or nursing-related services in a state-licensed or state-certified health care setting involving direct patient care for monetary compensation within the prior twenty-four months in either the facility or setting or fails to meet renewal requirements, that nurse aide shall complete the certification requirements of section 16-89A-3 anew' (HAR 16-89A-4(d)) — that is, training and the full examination again, not a simple late fee. The registry entry goes too: 'The registry shall remove an entry for a nurse aide who has not performed nurse aide services for twenty-four consecutive months, unless that entry includes documented findings of abuse, neglect, or misappropriation of resident's property, in which case the entry shall remain permanently' (HAR 16-89A-6(a)). 'If, after removal from the registry, a nurse aide wishes to be restored to the registry, that nurse aide shall complete the certification process as a new applicant' (16-89A-5(e)). Hawaii publishes no grace period and no late fee: no provision in HRS chapter 457A, HAR chapter 16-89A, HAR chapter 17-1445 or either state form sets out a route, a window or a fee for renewing a certification after it has expired, and the rule quoted above sends a lapsed aide back through certification anew. One qualification on how far that negative reaches: HRS 457A-9, added in 2025, repeatedly regulates 'an application to renew, restore, or reinstate a certification' and directs the director to deny one on a disqualifying conviction. The chapter therefore contemplates such applications, so read the absence as 'Hawaii does not publish the terms of a late-renewal route', not as 'no such application exists'. The contractor's lapsed routes split by whether the original program still exists: Path 1, for an aide who trained at a program that is still on the state-approved list, requires only the testing fees and both tests; Path 2, for an aide whose program 'is no longer in operation or is not listed as a current state approved training program', requires retraining at a currently approved program before testing. Findings are permanent and public: 'Nurse Aides with administrative findings or convictions for resident abuse, neglect and/or misappropriation of resident property will remain on the Registry with the findings placed in their record. These findings and/or convictions make the nurse aide ineligible for employment in any Hawaii long-term care facility. Findings and convictions are public information and are disclosed to anyone who verifies an individual's standing on the Registry.' A finding must be reported to the registry 'within ten working days of that finding', it stays permanently, and only three things remove it: 'The finding was erroneous, a court found the nurse aide not guilty, or the State is notified of the nurse aide's death' — or, for the department that made it, a determination that 'The nurse aide's employment and personal history does not reflect a pattern of abuse, neglect, or misappropriation of resident's property' and that the conduct 'was a singular occurrence' (HAR 16-89A-6(b)). Who hears an appeal matters in Hawaii: because commerce and consumer affairs does not make the substantiated findings, 'Any appeal regarding the reporting and placement of a substantiated finding in the registry shall be made to the department of health or the department of human services, whichever department was responsible for reporting that finding' (HAR 16-89A-5(b)(5)), with a contested case hearing available under HRS chapter 91.",
   "reciprocity": "Hawaii grants reciprocity by statute on both certification tracks, and the wording differs slightly between them. For a medicare or medicaid nurse aide: 'Reciprocity shall be granted to nurse aides who have completed a state-approved program that meets both federal and state requirements' (HRS 457A-7(c)). For the state-licensed and state-certified settings track: 'Reciprocity shall be granted to qualified nurse aides who have completed a state-approved program, the requirements of which are comparable to the requirements of this chapter' (457A-8(d)). The rule uses the comparability test generally: 'Reciprocity certification shall be granted to a qualified nurse aide from another state whose requirements are comparable to the certification requirements of this subchapter' (HAR 16-89A-3(c)). How it is applied, from the state-approved bulletin's Route 2: 'Select this certification option if you have been certified as a nurse aide in another state. The DCCA will determine whether you will be added directly to the Hawaii NA Registry or whether you will be required to take the Competency Exam' — so the outcome is a state decision rather than an automatic transfer. The applicant submits the application form and 'a copy of your current active CNA certificate. (Certificate must include expiration date and name of the state you are transferring from)', pays the $27 reciprocity fee plus the one-time $25 initial application processing fee, and lists every state where they have been certified along with current employment details. Status is checked at the source: 'Prometric will contact all other states to verify your status on their Registries before transferring your certification through reciprocity. If your certification is not current (active), you will be required to take the Competency Exam.' A person already deemed to meet the federal requirements can also enter the registry that way — the register covers aides certified by the department, aides deemed to meet the requirements by reciprocity, and aides 'deemed to have met the requirements pursuant to 42 C.F.R. 483.150(b)' (HAR 16-89A-5(a)). An out-of-state finding follows the person: 'If there is a substantiated finding of resident abuse, neglect, or misappropriation of resident's property from another state's registry against an individual applying as a nurse aide in this State, that finding shall be listed in this State's registry' (HAR 16-89A-5(b)(5)).",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Hawaii DCCA Professional and Vocational Licensing — Licensing Area: Nurse Aide. The program's home page. Establishes that the regulating body is the 'Department of Commerce and Consumer Affairs – Director'; that candidates should 'Contact Prometric at: www.prometric.com/nurseaide/hi to: Download an application for an exam or reciprocity. Obtain exam information, Candidate Information Bulletin. Verify a nurse aide certification'; the links to the CNA Registry lookup and the Candidate Information Bulletin; that training programs and formal complaints about training are handled by the 'Department of Human Services – Med-QUEST Division' on (808) 586-7752; the Adult Protective and Community Services Branch phone numbers by island; and the military renewal and restoration provision for licenses that expire while a service member is deployed.\", \"url\": \"https://cca.hawaii.gov/pvl/programs/nurse/\"}, {\"label\": \"Hawaii Revised Statutes chapter 457A (Nurse Aides) as published by the Hawaii State Legislature — the current, authoritative text, section by section. Establishes the legislative findings; all definitions including the post-2016 'State-licensed or state-certified health care settings' (regulated by the department of health only); the three-agency division of implementation with the 24-hour continuing-education ceiling in 457A-2(c); the commerce director's registry duty and the limit on that director's role in substantiated-findings discipline; the authority to contract with a professional testing service; the title-protection provision covering 'C.N.A.'; both certification sections with their reciprocity, recertification and fee provisions; and 457A-9, the 2025 automatic revocation and denial-of-restoration provision for convictions requiring sex-offender registration. A second copy of this chapter exists and should not be relied on: the DCCA licensing division publishes a PDF of ch. 457A stamped 'Amended 0709'. It reflects the chapter as it stood in July 2009, it is still downloadable and unchanged, and it therefore shows a definition, a subsection structure and a section count that the Legislature has since superseded. Everything this page quotes from chapter 457A is quoted from the Legislature's current text.\", \"url\": \"https://www.capitol.hawaii.gov/hrscurrent/Vol10_Ch0436-0474/HRS0457A/\"}, {\"label\": \"Hawaii Administrative Rules title 16 chapter 89A (Nurse Aide), Department of Commerce and Consumer Affairs, adopted December 24, 2008 and effective February 12, 2009. Establishes the certification requirements including 'a passing score of seventy per cent on the test' and the five randomly selected skills, reciprocity certification, hearing rights on denial, the biennial recertification requirements for both the medicare/medicaid and state-licensed tracks, the one-month filing deadline and the 'Lack of notification by the department shall not be a valid reason' rule, the registry's required contents including 'verification that the nurse aide is at least eighteen years of age', the confidentiality and disclosure rules, the ten-working-day reporting of findings, the power to contract registry operations to a non-state entity, and removal of registry entries after 24 consecutive months.\", \"url\": \"https://cca.hawaii.gov/wp-content/uploads/2026/02/har_89a-c1.pdf\"}, {\"label\": \"Hawaii Administrative Rules title 17 chapter 1445 (Recertification of Nurse Aides in State-Licensed or State-Certified Health Care Settings), Department of Human Services, effective July 12, 2013. Establishes the 24 continuing-education hours in the two years before expiry, the acceptable subject areas, the competency evaluation signed by a registered nurse instructor or evaluator, Option A (a 24-hour course of study through a state-certified program) and Option B (24 hours of continuing education class instruction plus an approved registered nurse evaluator), the rule that such settings 'may or may not require recertification', and the reporting duty back to the Department of Commerce and Consumer Affairs.\", \"url\": \"https://humanservices.hawaii.gov/wp-content/uploads/2013/01/17-1445-CNA-Recertification.pdf\"}, {\"label\": \"State of Hawaii Department of Human Services, Med-QUEST Division, Medical Standards Branch — State Certified Nurse Aide Training Program (the requirements document, dated May 11, 2004, published on Med-QUEST's Certification Programs page). Establishes the Medicaid agency's role in setting curriculum and certifying programs; the instructor and supplemental-personnel qualifications; the Minimum Curriculum — 'A minimum of 100 clock hours of training', 'Thirty (30) hours or more must be spent in classroom activities of which at least sixteen (16) hours of training must be in the following areas PRIOR to any direct contact with residents (patients)', and 'A minimum of seventy (70) hours must be in a supervised practical training' with 'Basic nursing skills—30 hours minimum; Basic personal care skills—30 hours minimum; and Basic restorative services—10 hours minimum'; the two-year term of state certification with site-visit and withdrawal rules; the 90-day decision timeline; and the Office of Health Care Assurance's survey role.\", \"url\": \"https://medquest.hawaii.gov/content/dam/formsanddocuments/resources/Provider-Resources/certification-programs/NATP-state-certified-nurse-aid-training-program.pdf\"}, {\"label\": \"Hawaii Med-QUEST Division — Certification Programs. The Medicaid agency's own page for the Nurse Aide Training Program, stating that 'Under Federal regulations, the Medicaid agency is the agency within the State that establishes the curriculum requirements for State certification of Nurse Aide Training Programs (NATPs) and determines the contents of the Competency Evaluation Programs. The Medicaid agency determines whether a NATP qualifies to be a State certified NATP', and publishing the requirements document, the curriculum submission format, the list of certified NATCEPs and approved registered nurse evaluators, the recertification reference material, and the separate Feeding Assistants Training Program.\", \"url\": \"https://medquest.hawaii.gov/en/plans-providers/certification-programs.html\"}, {\"label\": \"Candidate Information Bulletin — State of Hawaii Certified Nurse Aide (the Hawaii Nurse Aide Licensing Information Bulletin published by the state's testing contractor and linked from the DCCA Nurse Aide Program page). Establishes the contract scope ('The Hawaii Department of Commerce and Consumer Affairs (DCCA) has contracted with Prometric to develop and administer its Nurse Aide Competency Exam and to manage the Nurse Aide (NA) Registry'), the three certification routes and the two lapsed paths, the complete fee schedule including the one-time $25 initial application processing fee and the $216 first-time exam fee, the three-attempts-within-two-years-of-first-test rule, the exam structure ('60 multiple-choice questions... 90 minutes'; five clinical skills with Handwashing and Indirect Care; 31 to 40 minutes; 'you must pass all five skills'), the English-only rule and the oral alternative, the score-report and certificate timelines, the 60-day appeals window with a 20-business-day response, the registry description and the permanence and publicity of findings, the 24-month certificate term with a 90-day reminder notice, the eight-hour work test for renewal, and the free name and address updates.\", \"url\": \"https://www.prometric.com/files/2022-09/HI%20NA%20Licensing%20Information%20Bulletin%209.27.22.pdf\"}, {\"label\": \"Hawaii Nurse Aide Testing/Out of State/Reciprocity Application Form (Rev. 20130521, published on the Hawaii nurse aide page the state links). Establishes the live fee schedule — one-time Initial Application Processing Fee $25, Written and Clinical Skills $216, Oral and Clinical Skills $216, Clinical Skills only $162, Written only $54, Oral only $54, Rescheduling $25, Reciprocity $27 — plus the three routes and their required documents, the 'Are you at least 18 years old?' question, the three mandatory conviction and discipline questions with the twenty-year conviction window, the reciprocity information block requiring every state of certification, and the regional test sites on Hawaii Island (Kona and Hilo), Oahu (West and East), Maui and Kauai.\", \"url\": \"https://www.prometric.com/files/HI_CNA_APP.pdf\"}, {\"label\": \"Hawaii Nurse Aide Registry Recertification Form (published on the Hawaii nurse aide page the state links). The clearest single statement of Hawaii's two-track renewal: 'Group 1: Medicare/Medicaid Long-Term care Facility (do not submit recertification fees)' versus 'Group 2: Licensed/Certified Health Care Setting (submit $27 recertification fee)', with Group 2 required to show either a completed 24-hour competency evaluation course or '24 hours of Continuing Education and a skills competency review' with a certificate. Also establishes the eight-hour work test under the supervision of a licensed or registered nurse, the rule that forms 'should not be submitted more than 30 days before your current certification expiration period', that the new period runs 'two years from expiration date', that employer verification 'must be signed by a Hawaii licensed health professional responsible for the development of the plan of care', and the three conviction and discipline questions with a two-year conviction window.\", \"url\": \"https://www.prometric.com/files/HI_RegistryRecertificationForm.pdf\"}, {\"label\": \"Hawaii State Nurse Aide Registry public lookup (operated for the Department of Commerce and Consumer Affairs by its contractor). Establishes the search fields, the employer-code option and the notice that employers are required to search the registry before employing a nurse aide.\", \"url\": \"https://registry.prometric.com/registry/publicHI\"}, {\"label\": \"Hawaii nurse aide exam page (Prometric, the contractor the DCCA names and links). The page publishing the Hawaii licensing information bulletin, the examination application, the registry recertification form, the certified NATCEP and approved registered nurse evaluator list, the written test content outline, the clinical skills checklist and instructions, and the link to the registry lookup.\", \"url\": \"https://www.prometric.com/nurseaide/hi\"}]",
   "page_url": "https://licensingatlas.com/cna/hi-cna/"
  },
  {
   "page_id": "ia-cna",
   "state": "Iowa",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Iowa Department of Inspections, Appeals, and Licensing (DIAL) — which maintains the Iowa Direct Care Worker Registry and approves nurse aide training and competency evaluation programs. DIAL is explicit that it does not award the credential itself: 'Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate.' The certificate comes from the community college, facility or private entity that taught the 75-hour course. Iowa's Board of Nursing licenses nurses and has no role here.",
   "board_url": "https://dial.iowa.gov/licenses/health-professions/cnas",
   "application_url": "https://dia-hfd.iowa.gov/",
   "renewal_cycle": "The certification does not expire. The registry status does. DIAL states the first half plainly — 'The certification itself does not expire' — and the second half just as plainly: 'To remain active on the registry, the aide must perform at least eight hours of qualifying employment in a two-year period. A CNA's standing on the registry expires if the CNA stops working as a CNA for 24 months.' The federal source is named: 'The Centers for Medicare and Medicaid Services (CMS) requires that a CNA perform at least a day of nursing or nursing-related duties every 24 months.' The aide cannot do this personally, and that is the point most often missed: 'the only way a CNA can remain active on the Iowa Direct Care Worker Registry is if their Iowa employer reports their hours to registry staff', and 'a CNA cannot report their own hours to the registry, nor can the CNA provide a letter verifying employment from the employer to DIA directly.' Who is obliged to report: 'Long-term care facilities are the only entities mandated by state and federal law to verify eligibility and report qualifying employment to the registry. In Iowa, health care employment agencies that employ CNAs at long-term care facilities must also report hours for their employees working in long-term care facilities.' Others may report but are not required to. How: electronically, by logging in to DIAL's Health Facilities Database / Direct Care Worker Registry — available to long-term care facilities and, DIAL lists, hospices, hospitals, home health care agencies and ambulatory surgical centres. Everyone else reports on paper: assisted living programs, intermediate care facilities, residential care facilities and group homes must send DIAL 'a job description and an attestation letter on facility letterhead to registry staff showing the CNA has performed at least eight hours of paid, nursing or nursing-related duties.' DIAL advises facilities to 'consider electronic verification of employment status at least yearly prior to their annual survey.'",
   "ce_hours": "No continuing education is required of the aide to keep registry status. What Iowa requires instead is work — eight hours of paid nursing or nursing-related duties in a 24-month period, reported by the employer. The 12-hour figure people quote is a facility duty and it attaches only to long-term care: 'long-term care facilities only are required to provide (and CNAs are required to complete) at least 12 hours of in-service training per year', which DIAL states elsewhere as 'If employed as a nurse aide in a certified long-term care facility, the facility must provide and the aide must complete 12 hours of in-service training per year.' Note the careful wording — the obligation to provide it runs to the facility, the obligation to complete it runs to the aide, and neither is described anywhere as a condition of remaining on the Direct Care Worker Registry. Checked across all DIAL nurse aide and registry pages and 441 IAC 81.13: no course, hour count, approved-provider list or renewal education requirement exists for the individual CNA.",
   "exam": "Two parts, both required, and a 70 percent pass mark. 'Successful completion of both written and skills tests is required to be placed on the Iowa Direct Care Worker Registry.' The rule sets the standard: 'A score of 70 percent or above is passing for both the written or oral and skills demonstration parts of the test' (441 IAC 81.13(4)'a'(1)) — note that Iowa's rule recognises an oral form of the knowledge test alongside the written one. Three attempts per part, and the penalty for failing: 'Each person shall have three opportunities to pass each part of the test. If one part of the test is failed, only that part need be taken a second or third time. If either part of the test is failed three times, the 75-hour course shall be taken or retaken before the test can be taken again' (441 IAC 81.13(4)'b'(2)). DIAL states the same rule on its candidate page: 'If a potential CNA does not pass either one of the tests in three attempts, they must retake the 75-hour course AND begin a new testing cycle.' A candidate who fails must be told in writing within ten working days after the test is scored which areas were not passed and that three opportunities exist. Results and reporting deadlines are in the rule, not just in practice: 'The competency testing entity shall inform the nurse aide of the test score within 30 calendar days of the completion of the test and shall inform the nurse aide registry of the nurse aide's scores within 20 calendar days after the test is administered', and 'A record of successful completion of the competency evaluation shall be included in the nurse aide registry within 30 days of the date the person is found to be competent.' DIAL's own candidate guidance says the wait is shorter in practice — 'please allow at least two weeks' — and its 2025 announcement said students who pass both parts 'will be automatically added to the Iowa Direct Care Worker (DCW) Registry within 10–14 days after test completion.' What Iowa does not publish: the number of questions on the written test, the time allowed, or the number and selection method of the skills demonstrated. Those were checked across every DIAL nurse aide page, 441 IAC 81.13, and the Iowa testing-request application, and are not stated; this page therefore gives no figure for them.",
   "fees": "Iowa charges no state fee to be placed on the registry, to renew, or to transfer in — none appears on any DIAL nurse aide page or in 441 IAC 81.13. What you pay is the training and the two tests. Testing, as DIAL currently publishes it: the written (knowledge) exam is '$50 for a proctored test taken at an Iowa community college' or, taken remotely online, '$50' via Headmaster or '$70' via Credentia; the skills exam is '$115' at an Iowa community college or '$135' with Health Tech Associates. A second, older set of figures sits on the same site and is reported here rather than suppressed: DIAL's summary box on the CNA page still says 'The cost for exams is about $60 for written test and $115 for the skills test', and its step-by-step placement page says 'The cost for exams are approximately $60 (written) $115 (skills).' The $50/$70/$115/$135 list is the one presented as current and is the one attached to the January 2026 change in how the written test is registered and paid for; the $60 figure is the one Iowa has not updated. Facility sponsorship of the written exam has its own form: 'If a facility plans to pay for an employee's written exam at a community college, the facility must complete the Facility Account Information Application (third-party sponsor application through Headmaster).' Training: 'The cost of the 75-hour training course is determined by the community college or entity where the course is offered. However, for aides working in a certified nursing home, this fee is typically paid by the employer.' Iowa publishes no tuition figure and sets no cap. If you paid and are then hired within 12 months, the pro rata reimbursement formula in 441 IAC 81.13(3)'a' applies — see requirements.",
   "legal_basis": "[{\"citation\": \"441 Iowa Admin. Code 81.13 (Nurse aide requirements and training and testing programs), Iowa Administrative Code edition 6/10/26; rule history [ARC 9279C, IAB 5/14/25, effective 7/1/25; ARC 9859C, IAB 12/24/25, effective 2/1/26]\", \"what_it_governs\": \"The operative Iowa nurse aide rule: which prior training is deemed to satisfy the requirement (including the pre-1989 routes and the military route), DIAL's approval of training and competency evaluation programs and the facility disqualifications and 75-hour waiver conditions, the two-year approval cycle and 90-day decision deadline, the pro rata training-cost reimbursement formula, the competency evaluation itself — the 70 percent pass mark for both the written or oral and skills parts, three attempts per part, and retaking the 75-hour course after a third failure — the reporting deadlines for scores, the establishment of the registry under 42 CFR 483.156, the 30-day registry application duty for employed aides, and the abuse-finding hearing procedure. The rule states that it 'is intended to implement Iowa Code section 249A.4' — Iowa's Medicaid statute — which is why it sits in the Human Services [441] chapter even though DIAL administers it.\", \"url\": \"https://www.legis.iowa.gov/docs/iac/chapter/441.81.pdf\"}, {\"citation\": \"441 Iowa Admin. Code 81.11(19) (Administration — required training of nurse aides)\", \"what_it_governs\": \"The definitions of 'nurse aide' and 'licensed health professional' that set who the requirement reaches, the facility's duty to ensure aides can demonstrate competency, and the four-month limit on using a person as a nurse aide, tied to 42 CFR 483.25(d).\", \"url\": \"https://www.legis.iowa.gov/docs/iac/chapter/441.81.pdf\"}, {\"citation\": \"Iowa Code ch. 135C (Health Care Facilities), 2026 edition — in particular 135C.1(4), 135C.33 and 135C.34\", \"what_it_governs\": \"The statute DIAL names as a code citation on its CNA page. 135C.1(4) settles the agency question for the whole chapter: 'Department means the department of inspections, appeals, and licensing.' 135C.33 carries the criminal history and abuse-record regime, including subsection 9, which defines a 'certified nurse aide training program', requires record checks before a student begins or returns to one, governs provisional participation, bars clinical involvement with children or dependent adults absent an evaluation, imposes the student's 48-hour reporting duty on pain of a serious misdemeanour, and deems the checks sufficient for employment if the student is hired by the training facility within 30 days. 135C.34 requires DIAL to run a medication-aide reciprocity route through the nurse aide and medication aide challenge examinations. Note for precision: chapter 135C contains no provision establishing the nurse aide registry, the 75-hour course or the competency evaluation — those live in 441 IAC 81.13.\", \"url\": \"https://www.legis.iowa.gov/docs/ico/chapter/135C.pdf\"}, {\"citation\": \"42 CFR Part 483, Subpart D — 42 CFR 483.151, 483.152, 483.154 and 483.156; and the facility-side 42 CFR 483.25(d)\", \"what_it_governs\": \"The federal frame Iowa adopts by direct reference rather than restating: programme approval standards (483.152, incorporated 'as amended to August 1, 2024'), withdrawal of approval (483.151(e)), the administration of the competency evaluation (483.154), the registry itself (483.156), and the four-month limit on using an untrained nurse aide (483.25(d)). DIAL lists 42 CFR Part 483 among its three code citations for CNAs.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483\"}]",
   "exam_vendor": "Split between the written and the skills test, and it changed in January 2026. Written (knowledge) test: 'Registration, payment, and exam records are handled by TestMaster Universe/Headmaster', and 'As of January 2026, community colleges now serve only as testing sites and proctors.' The written test may also be taken 'remotely online via Headmaster ($50) or Credentia ($70).' Skills test: taken either at an Iowa community college — 'This is managed through the college and not via Headmaster or Credentia' — or from Health Tech Associates, a private entity on DIAL's own approved list. How the vendors got there: DIAL announced the arrangement itself on June 2, 2025 — 'DIAL has contracted with two nationally recognized testing providers—Headmaster and Credentia—to offer secure, remote online written testing for CNA candidates across the state', with the caveat that 'students will still be required to complete the skills test onsite at approved locations to demonstrate practical competencies.' Iowa does not use the NNAAP name for its examination; the rule calls it the 'nurse aide competency evaluation' and requires it to be 'administered in accordance with 42 CFR 483.154.'",
   "training_hours": "75 hours, of which 30 are clinical. DIAL states both numbers in one sentence: 'Must either enroll themselves or be sponsored by their employer to take the 75-hour course and competency tests provided by a testing site. Thirty of the 75 course hours are clinical.' The '75-hour course' is the phrase Iowa uses everywhere — on the CNA page, on the training page, in the list of approved facilities and private entities, and in the rule itself, which speaks of '75-hour nurse aide training courses offered in (but not by) a facility' (441 IAC 81.13(2)'f'). Where the number comes from, precisely: Iowa's administrative rule does not restate 75 as a freestanding requirement; it adopts the federal programme standards by reference — 'Policies and procedures governing approval of the programs are set forth in 42 CFR 483.152' — and then uses 75 hours as the settled figure throughout. The 30-clinical-hours split is published by DIAL rather than by the rule; no Iowa rule text we checked states the classroom/clinical division. Where the course may be taken: 'Iowa's community colleges offer training for individuals interested in becoming certified nursing assistants (CNAs). The colleges offer both classroom studies and hands-on clinical training. Additionally, some health care facilities and private entities also offer the CNA course.' DIAL publishes the current lists of approved health care facilities and private entities on its CNA page and names them individually. Program approval runs on a two-year cycle: applications go to DIAL 'before a new program begins and every two years thereafter'; DIAL responds within 90 days; and it 'will not grant approval of a nurse aide training and competency evaluation program for a period longer than two years' (441 IAC 81.13(2)'c' and 'd'). Some facilities are disqualified from hosting training at all — a facility that in the previous two years operated under a nurse staffing waiver over 48 hours per week, was subject to an extended or partial extended survey, was assessed a civil money penalty of at least $5,000, operated under temporary management, was closed or had residents transferred by state action, was terminated from Medicaid or Medicare, or was denied payment. DIAL publishes that consequence as a searchable list: the 'Nurse Aide Denial List... this list of facilities that have lost the privilege of providing CNA training.'",
   "lapse_rule": "Status expires after 24 consecutive months without qualifying work, and there are two ways back — one of them retroactive. DIAL: 'If a nurse aide does not work as a CNA for two years or more, the aide will have to retake both competency tests to get their status updated on the registry and to be eligible to work at a long-term care facility in Iowa.' The other route, which the headline sentence omits, is to prove work that was never reported: once a status has flipped from active to expired, 'the employer (facility administrator or director of nursing for any entity type) must notify DIAL. They cannot do this electronically (even if they are an entity that is normally allowed to update hours electronically).' The employer sends a letter on facility letterhead containing 'a testament that the CNA performed at least eight hours' worth of nursing or nursing-related duties while the CNA was in the facility's employment — after the date they were last verified, but before they expired on the registry (list the specific duties)' — plus the CNA's full name, registry ID number, hire date and separation date. Again, the aide cannot do this for themselves. A finding is a different and permanent-looking thing: 'Individuals who are found guilty of abusing, neglecting, or mistreating residents by a court of law or who have a finding of abuse, neglect, mistreatment, or misappropriation of resident property will be designated as not eligible for employment on the Iowa Direct Care Worker Registry.' The process behind it is in the rule: DIAL investigates an abuse allegation, notifies the aide of a finding and of the right to a hearing, and 'The nurse aide shall have 30 days to request a hearing'; after 30 days, if the aide does not appeal or once appeals are exhausted, 'the nurse aide registry will include a notation that the nurse aide has a founded abuse report on record if the final decision indicates the nurse aide performed an abusive act' (441 IAC 81.13(6)). No Iowa source we checked publishes a route to remove such a notation.",
   "reciprocity": "Iowa calls it a transfer and runs it as an online application on the registry site. DIAL: 'When a CNA wants to transfer to Iowa from another state registry, they may apply online [at] the Direct Care Worker Registry website. Processing time varies; please allow at least two weeks.' The registry site presents it in the same door as a new application — 'Complete your online application for the Iowa Direct Care Worker Registry and out-of-state reciprocity.' You need a registry account first: 'If you don't already have an account or need to know if you have an account on the Iowa Direct Care Worker Registry, to [sic] you will need to register for an account.' Outbound transfers are the other state's process: 'If you wish to transfer from Iowa to another state registry, please first contact the registry in that state.' What Iowa does not publish, and it was checked across every DIAL nurse aide and registry page and 441 IAC 81.13: any fee for the transfer application, any good-standing or currency condition on the out-of-state registry entry, any documentation list, and any examination requirement or waiver for an incoming aide. This page therefore states none of those. The one adjacent statutory rule that is published concerns the medication aide rather than the nurse aide — Iowa Code 135C.34 requires DIAL to let an out-of-state certified medication aide certify here 'upon completion and passage of both the certified nurse aide and certified medication aide challenge examinations, without additional requirements for certification, including but not limited to, required employment in this state prior to certification' — which shows that a 'challenge examination' route exists in Iowa, and the state's testing-request application confirms it by listing 'You are eligible to challenge' alongside completion of an approved training program as grounds for testing.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Iowa Department of Inspections, Appeals, & Licensing — Certified Nursing Assistants (CNAs). The main CNA page. Establishes 'Plans for all CNA courses taught in Iowa need to be approved by DIAL, but DIAL does not issue the certificate. A nurse aide is certified in Iowa, not licensed'; the three code citations (441 IAC ch. 81, Iowa Code ch. 135C, 42 CFR Part 483); the 75-hour course with 'Thirty of the 75 course hours are clinical'; the six-digit registry ID; 'The certification itself does not expire'; the eight-hours-in-24-months rule and the 24-month expiry; the 12-hour annual in-service duty; the abuse/neglect ineligibility rule; the January 2026 change making community colleges 'only as testing sites and proctors'; the $50/$70/$115/$135 testing costs alongside the older 'about $60 for written test and $115 for the skills test'; the Facility Account Information Application for employer-paid written exams; the named lists of health care facilities and private entities approved to teach the course; and the Nurse Aide Denial List.\", \"url\": \"https://dial.iowa.gov/licenses/health-professions/cnas\"}, {\"label\": \"Iowa DIAL — How Do I Get Placed on the Iowa Direct Care Worker Registry? Establishes that CNAs 'must be listed on the Iowa Direct Care Worker Registry to be eligible for work in an Iowa long-term care facility (nursing home, skilled nursing facility, or a skilled or swing bed unit of a hospital)' and that 'CNAs do not need to be on the registry to work in other types of facilities'; 'If a potential CNA does not pass either one of the tests in three attempts, they must retake the 75-hour course AND begin a new testing cycle'; 'The candidate must pass both a written and a skills test within four months of their hire date'; the two-week processing note; and the statement that 'Testing is only provided at one of the community colleges. Other organizations that offer the training do not provide testing.' That statement conflicts with DIAL's own CNA page and training page, which offer the written test remotely online via Headmaster or Credentia and the skills test with Health Tech Associates, a private entity; this page follows those newer pages and reports the conflict rather than choosing silently.\", \"url\": \"https://dial.iowa.gov/licenses/health-professions/cnas/how-do-i-placement-dcw-registry\"}, {\"label\": \"Iowa DIAL — How Do I Stay Active on the Iowa DCW Registry? Establishes the CMS 24-month work rule, the 12-hour annual in-service duty on long-term care facilities, the exclusive reporting duty of long-term care facilities and health care employment agencies, 'the only way a CNA can remain active on the Iowa Direct Care Worker Registry is if their Iowa employer reports their hours to registry staff', the list of entity types that can report electronically (hospices, hospitals, home health care agencies, ambulatory surgical centres) and those that must report by letter (assisted living programs, intermediate care facilities, residential care facilities, group homes), the letterhead-attestation requirements, and 'a CNA cannot report their own hours to the registry'.\", \"url\": \"https://dial.iowa.gov/licenses/medical/direct-care/how-do-i-staying-active-registry\"}, {\"label\": \"Iowa DIAL — How Do I Become Active After my Status Expires on the DCW Registry? Establishes that the employer must notify DIAL and cannot do so electronically once a status has flipped to expired, and the exact contents of the required employer letter: the testament of at least eight hours of nursing or nursing-related duties performed after the last verification but before expiry, with specific duties listed, plus the CNA's full name, registry ID number, hire date and separation date.\", \"url\": \"https://dial.iowa.gov/licenses/medical/direct-care/how-do-i-become-active-after-status-expires\"}, {\"label\": \"Iowa DIAL — How Do I Transfer To/From the Iowa DCW Registry? Establishes that an incoming transfer is filed online at the Direct Care Worker Registry website with at least two weeks' processing, that a registry account is needed first, and that an outbound transfer starts with the receiving state's registry.\", \"url\": \"https://dial.iowa.gov/licenses/medical/direct-care/how-do-i-transfer-tofrom-iowa-dcw-registry\"}, {\"label\": \"Iowa DIAL — How Do I Verify the Status of a CNA on the Iowa DCW Registry? Establishes the audience and the search keys ('by first and last name, city, county of residence, and registry number'), that 'This registry number is the only unique identifying number that DIAL can publicly share or confirm', the refusal to search by date of birth or Social Security number, and that 'Search results can be downloaded as PDF or CSV files.'\", \"url\": \"https://dial.iowa.gov/licenses/medical/direct-care/how-do-i-verify-cna-status\"}, {\"label\": \"Iowa DIAL — Iowa Direct Care Worker Registry (the registry programme page). Establishes 'In Iowa, only certified nursing assistants (CNAs), also called nurse's aides, are placed on the Direct Care Worker Registry', 'CNAs are only required to be on the registry if they are seeking employment in a long-term care facility', the reporting-duty summary, 'DIAL does not have copies of a CNA certificates', and how to print a registry card from a logged-in registry account.\", \"url\": \"https://dial.iowa.gov/licenses/health/direct-care-worker-registry\"}, {\"label\": \"Iowa DIAL — How Do I Find a CNA Training Course or Testing Location? Establishes the current testing routes and prices in DIAL's own numbered steps: the written exam at an Iowa community college ($50, registration and payment through TestMaster Universe/Headmaster since January 2026) or remotely online via Headmaster ($50) or Credentia ($70); the skills exam at an Iowa community college ($115, 'managed through the college and not via Headmaster or Credentia') or with Health Tech Associates ($135).\", \"url\": \"https://dial.iowa.gov/how-do-i-cna-training\"}, {\"label\": \"Iowa DIAL press release, June 2, 2025 — 'DIAL Expands CNA Testing Access with New Online Exam Options'. Establishes that 'DIAL has contracted with two nationally recognized testing providers—Headmaster and Credentia—to offer secure, remote online written testing for CNA candidates across the state', that the skills test remains onsite, that passing candidates 'will be automatically added to the Iowa Direct Care Worker (DCW) Registry within 10–14 days after test completion', and that 'Neither testing nor placement on the registry are required for CNAs who plan to work in an assisted living facility, hospital, or other health care facility that is not a nursing home.'\", \"url\": \"https://dial.iowa.gov/press-release/2025-06-02/dial-expands-cna-testing-access-new-online-exam-options\"}, {\"label\": \"441 Iowa Administrative Code chapter 81 (Nursing Facilities), IAC edition 6/10/26, official PDF from the Iowa Legislature. Establishes rule 81.13 in full — the deemed-completion routes including the military route, the programme approval regime and its facility disqualifications and 75-hour in-facility waiver, the pro rata reimbursement formula, the 70 percent pass mark, the three-attempts-per-part rule and the retake-the-course consequence, the score reporting deadlines, the registry establishment and the 30-day registry application, and the abuse-finding hearing procedure — together with rule 81.11(19)'s definitions of 'nurse aide' and 'licensed health professional' and the four-month limit.\", \"url\": \"https://www.legis.iowa.gov/docs/iac/chapter/441.81.pdf\"}, {\"label\": \"Iowa Code chapter 135C (Health Care Facilities), 2026 edition, official PDF from the Iowa Legislature. Establishes that 'Department means the department of inspections, appeals, and licensing' (135C.1(4)); the certified nurse aide training programme record-check regime in 135C.33(9) including the definition of the programme, the pre-enrolment checks, provisional participation, the record check evaluation system's final authority, the student's 48-hour reporting duty and serious-misdemeanour penalty, and the 30-day hiring deemer; and the medication aide reciprocity route through 'the certified nurse aide and certified medication aide challenge examinations' (135C.34).\", \"url\": \"https://www.legis.iowa.gov/docs/ico/chapter/135C.pdf\"}, {\"label\": \"Iowa Direct Care Worker Registry & Health Facility Database (DIAL's own application). The live tool behind the license search on this page: its DCW search section ('Look up eligibility status of Direct Care Workers') and its search inputs — identification number, first name, last name, city and a 99-county multi-select — and its application entry point, 'Complete your online application for the Iowa Direct Care Worker Registry and out-of-state reciprocity.'\", \"url\": \"https://dia-hfd.iowa.gov/\"}, {\"label\": \"Iowa Nurse Aide Testing Request application, TestMaster Universe (D&SDT-Headmaster) — the testing application DIAL links for the written examination. Establishes the two eligibility grounds Iowa recognises for sitting the competency exam ('You have completed an approved training program' / 'You are eligible to challenge'), and that the approved Iowa training programmes are selected from a fixed list inside the application.\", \"url\": \"https://ia.tmutest.com/apply/9\"}]",
   "page_url": "https://licensingatlas.com/cna/ia-cna/"
  },
  {
   "page_id": "id-cna",
   "state": "Idaho",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Idaho Department of Health and Welfare (IDHW) — Licensing and Certification, Bureau of Facility Standards, Idaho Nurse Aide Program (the CNA Registry and the Nurse Aide Training and Competency Evaluation Program)",
   "board_url": "https://healthandwelfare.idaho.gov/providers/certified-nurse-assistant/about-certified-nurse-assistant-registry",
   "application_url": "https://www.prometric.com/exams/nurseaide-id",
   "renewal_cycle": "Every 24 months, free, and renewed on documented paid work — with an Idaho twist that catches people out: The new expiry date is measured from the last day worked, not from the old expiry date. The Department explains it with its own worked example: 'Certificate expiration dates are based on your last day worked as a CNA, and calculated 24 months from that date. Federal regulations state CNAs must have performed eight (8) hours of paid nursing or nursing-related services during a 24 consecutive month period. For example, if the CNA's certificate showed an expiration date of June 2026 and their last day worked was in June 2025, their renewed certificate would show an expiration date of June 2027 (24 months after the last day worked), not June 2028 (2 years after the expiration date).' The work test: 'You must have worked a minimum of 8 hours as a paid CNA or in nursing-related services. Employment dates need to be prior to your CNA certification lapsing', and the renewal form is blunt about what does not count: 'Volunteer hours DO NOT count as hours towards renewing your certification.' When to file: 'You should renew during the month of your certification expiring. We recommend that you submit your renewal request at the beginning of the month it expires', and the form's own instruction is 'Send your renewal form in the SAME month of expiration date.' The candidate bulletin adds that 'A renewal reminder will be mailed to you approximately 45 days prior to the expiration of your certification.' How it is filed: the aide completes the Idaho Nurse Aide Renewal Form and signs it 'to authorize your employer to release employment information to the Idaho Nurse Aide Registry'; the 'CURRENT or MOST RECENT CNA, Home Health Aide, or Personal Care services EMPLOYER' completes the verification block with start and end dates and signs. Personal-care work needs extra proof: 'If you provided personal care services you MUST include proof of payment for your work (checks or paystubs) in addition to the employer signature.' If the old employer will not sign, the Department accepts substitutes: 'You must submit a copy of your W-2 or pay stub(s) with your employer's information for the timeframe you are stating you worked as a CNA or performed nurse aide related work.' Completed forms go by fax to (208) 334-6629, by email to IDNAP@dhw.idaho.gov, or by post to the Idaho Nurse Aide Registry, Licensing and Certification–Bureau of Facility Standards, P.O. Box 83720, PTC 6th Floor, Boise ID 83720-0009. Employers may renew online through the vendor's Employer Renewal Form. Confirmation depends on the channel: 'If you emailed your renewal to the Idaho Nurse Aide Program, you will receive an email stating your renewal has been processed. If you submitted your renewal by fax or US mail, you will not receive confirmation of processing, however, you can check your status online at the CNA registry website.' A certificate carrying an abuse finding can still be renewed, but marked: 'If a nurse aide with a substantiated complaint of abuse, neglect, or misappropriation of resident's property applies for renewal of their certification, such certification may be processed. The new Idaho Nurse Aide Registry card for such a nurse aide shall be noted with the following: Prohibited to Work in a Medicare/Medicaid Facility under 42 CFR 483.156.'",
   "ce_hours": "Idaho requires no continuing education to renew a CNA certificate. Renewal turns on documented paid work and nothing else: the Department's renewal instructions and its renewal form set out one condition — at least eight hours of paid CNA or nursing-related work in the 24-month period, verified by the employer — and no Idaho source we checked adds a course, an in-service requirement or an hour count for the individual aide. Sources checked: the Department's Certified Nurse Assistant Registry page including its full renewal, reciprocity and testing FAQs; the Idaho Nurse Aide Renewal Form (revised 9.7.2023); the Idaho Reciprocity Form (revised 9.07.2023); the Department's Skilled Nursing Provider Resources page and its NATCEP FAQ; the Idaho Nursing Assistant 2021 Curriculum in full, including its 'IDAHO CNA RE-CERTIFICATION REQUIREMENTS' section — which contains no hour requirement at all and simply directs instructors and students to contact the Idaho CNA Registry; and the state-approved candidate bulletin. The one recurring education duty found in these sources falls on instructors, not on aides, and it is a recommendation rather than a rule: 'IDCTE recommends that the regional career-technical college/university offer eight (8) hours of annual continuing education related to nursing assistant education or practice for instructors needing to maintain a CTE occupational specialist teaching certificate', and manual skills raters 'must meet Primary Instructor requirements and attend annual training.' Nothing on this page claims that Idaho employers are free of the separate federal in-service obligations that apply to nursing facilities; those bind the facility rather than the certificate, and no Idaho source we checked addresses them.",
   "exam": "Two tests, taken in a fixed order, with two different deadlines. Manual skills test — administered by one of the six regional career-technical colleges or an approved registry-contractor site, using 'approved procedures and testing scenarios' from the current Rater Guidelines. Every graduate of a state-approved program 'is allowed three (3) opportunities to pass the manual skills test' and 'is allowed six (6) months from program completion to pass the manual skills test.' Identity is checked on the day 'through a visual check of a valid government issued picture ID at the testing site, by the exam rater.' Fail three times and the course must be repeated: 'If the manual skills test candidate is unsuccessful after three (3) attempts at the examination, he or she must successfully complete another nursing assistant program and successfully pass state testing to be placed on the Idaho Registry.' An extension is possible but only for the skills side: 'If the candidate has not exhausted all three (3) opportunities to test at six (6) months, he or she may request an extension from IDHW... The extension will not apply to the written exam.' Written (knowledge) test — computer-delivered at the training program, with a tutorial first and no computer experience needed. 'The Written (Knowledge) exam consists of 60 multiple-choice questions that test your overall knowledge of information required as a nurse aide caring for nursing home residents. You will have 90 minutes to complete the exam.' The score report prints immediately, pass or fail, and the pass rule is a total rather than a per-domain one: 'To pass the Written or Oral exam, you must get an overall number of questions correct. It is not necessary to pass each content area. This makes it possible to have a fail in several of the content areas on the exam and still have an overall result of pass.' No numeric passing score is published in any Idaho source we checked. Three attempts, one year from program completion, and an extension available from the Department for cause. Oral form — 'The Written (Knowledge) exam may also be taken in an oral format. During an oral test, you will hear the questions read to you while reading and answering questions on the computer. You may replay questions as many times as needed', and the state curriculum makes it a program obligation rather than a favour: 'All students are provided an oral option for testing.' The candidate selects it on the application. Language — the examination is offered only in English; 'Translators are not permitted and translation dictionaries may not be used during the exam administration', with the oral format offered as the alternative for candidates with a reading disability, limited reading skills or English as a second language. Identification — a current government-issued photo identification plus a Social Security card or a Social Security Administration letter; the number is used as the primary identifier in the registry database. Where — testing is arranged with the training program, not with the vendor: 'Your exam will be scheduled at your training program or the program assigned to you by Idaho Department of Health and Welfare. It is your responsibility to set up a test date and time directly with the training program', and the application is brought to the test site rather than mailed: 'Do not send this application to Prometric or the Idaho Department of Health and Welfare.' Accommodations — requested in writing with the testing application and supporting documentation such as a physician's or specialist's letter on official letterhead, with 'Fifteen days' advance notice' required and 'no additional charge for these accommodations.' Appeals — in writing within 60 days of the exam date, answered within 10 business days; 'Faxed appeals will not be accepted because an original signature is required.'",
   "fees": "The state charges nothing for the credential itself. The Department answers the question directly: 'Is there a charge to renew my certification? No, at this time, there are no fees to process any forms or certifications with the Idaho Certified Nurse Aide Registry', and the renewal form repeats it in capitals: 'There is NO fee required to renew your CNA certification.' The one Department-side charge found is for replacing paper: a duplicate certificate or replacement card is requested on the CNA Change Request Form and 'There is a $15 processing fee for these actions.' What the written exam costs, and a conflict between two vendor documents: the candidate bulletin lists 'Written Exam $34 + testing site fees' and 'Oral Exam $34 + testing site fees', while the Idaho Nurse Aide Testing Application prices them separately at 'Written Exam $29' and 'Oral Exam $39'. Both are recorded and attributed; the application is the form the candidate completes at the test site and the bulletin is the older document. Either way there is a second charge the state does not set: 'There may be additional test administration fees charged by the training program', and the bulletin says the same thing twice — '+ testing site fees' and 'Additional fees paid directly to the testing site will be required.' Those amounts are set by each college or facility and are not published by the Department or the vendor. Rescheduling — 'No fee if you reschedule up to five full working days before your test' and 'A full exam fee if you reschedule on the fourth business day or less prior to your appointment date'; a missed or late appointment costs the fee again. 'Exam fees are nonrefundable and nontransferable. Fees will only be returned to candidates who are determined to be ineligible to test.' Payment for the written exam is by Visa, American Express or MasterCard entered directly into the testing system. Manual skills test fees are not published anywhere we could read — the skills test is administered by the colleges rather than by the vendor, and neither the Department's pages nor the vendor's Idaho documents state what a college charges for it. No reciprocity fee is stated on the Department's reciprocity form or its FAQ, consistent with the Department's blanket 'no fees to process any forms or certifications' statement. Optional practice material, required by nobody: the Nurse Aide Practice Exam 'contains 50 questions. The fee for each practice exam is $10.' Training tuition is set by the college, high school or facility running the program and is not published by the Department.",
   "legal_basis": "[{\"citation\": \"42 C.F.R. part 483, subpart D (sections 483.150 through 483.158) — the federal nurse aide training, competency evaluation and registry rules, implementing sections 1819(b)(5), 1819(f)(2), 1919(b)(5) and 1919(f)(2) of the Social Security Act\", \"what_it_governs\": \"The entire framework Idaho operates. The Department states that 'The Nurse Aide Training and Competency Evaluation Program (NATCEP) in the state of Idaho follows the requirements as stated in federal regulations, 42 CFR Chapter IV Subchapter G Subpart D', and the state curriculum cites 483.151 (state review and approval of programs), 483.152 (requirements for approval of a training and competency evaluation program) and 483.154 (nurse aide competency evaluation) as the authority for its curriculum requirements. Section 483.156 is the provision behind the registry notation 'Prohibited to Work in a Medicare/Medicaid Facility'. Idaho has no separate CNA licensing act, which is why these federal sections and the state curriculum carry the weight a licensing statute carries elsewhere. The federal texts themselves were not read as of August 16, 2026; they are cited here as Idaho cites them, and the Department publishes its own copies of 483.150 through 483.156 alongside its NATCEP materials.\", \"url\": \"https://healthandwelfare.idaho.gov/providers/skilled-nursing/skilled-nursing-provider-resources\"}, {\"citation\": \"Idaho Nursing Assistant Curriculum (2021), adopted by the Idaho Department of Health and Welfare and the Idaho Division of Career Technical Education\", \"what_it_governs\": \"The state-approved curriculum that every Idaho nurse aide training program must use, and the document that carries Idaho's operative rules on training hours, faculty qualifications, clinical ratios and settings, testing administration, attempt limits and deadlines. It functions as the state layer on top of the federal regulations: 'All programs must use State approved curriculum. This curriculum must be used for all nursing assistant training in Idaho.'\", \"url\": \"https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=28194&dbid=0&repo=PUBLIC-DOCUMENTS\"}, {\"citation\": \"Idaho Admin. Code 24.34.01 (Rules of the Idaho Board of Nursing), Subsection 002.31, dated 3-28-23\", \"what_it_governs\": \"The definition of Unlicensed Assistive Personnel, which is the category Idaho places CNAs in, and the limits on what may be delegated to them — including the bar on performing 'any licensed nurse functions that are specifically defined in Section 54-1402, Idaho Code' and on being delegated acts requiring nursing assessment or diagnosis, establishment of a plan of care or teaching, the exercise of nursing judgment, or procedures requiring specialized nursing knowledge, skills or techniques. Note the citation form: the Department of Health and Welfare cites this as '24.34.01.31'; in the rule as published, the definition sits at Section 002, Subsection 31.\", \"url\": \"https://adminrules.idaho.gov/rules/current/24/243401.pdf\"}, {\"citation\": \"Idaho Code 54-1402 (Idaho Nursing Practice Act — definition of the practice of nursing), as applied through the Board of Nursing rules\", \"what_it_governs\": \"The licensed-nurse functions that unlicensed assistive personnel, including CNAs, are prohibited from performing. Cited by Idaho Admin. Code 24.34.01.002.31 and reproduced in the Department of Health and Welfare's own scope-of-practice answer. The statutory text itself was not read as of August 16, 2026, and nothing on this page is quoted from it.\", \"url\": \"https://adminrules.idaho.gov/rules/current/24/243401.pdf\"}]",
   "exam_vendor": "Two different administrators for the two halves of the exam, which is what makes Idaho unlike most states. The manual skills test is run by the colleges: 'Testing competency evaluation programs shall be administered through one of the six Idaho regional career-technical colleges/universities, or an NA Registry contractor approved by IDHW', and the Department's own training overview says the manual skills test is 'Provided by six career-technical colleges/universities', where 'Raters are employed by colleges and must meet Primary Instructor requirements and attend annual training.' Evaluation 'must be conducted at the career-technical college/university, or an approved IDHW NA Registry contractor site', and independence is required: 'The person evaluating the manual skills test cannot have been involved with any portion of the didactic lab or clinical components of the training program. This includes the course instructor, a nurse employed by a facility if the training took place in that facility, or a nurse employed in the same facility as the nurse aide.' The written test is run by a state-approved vendor: 'The Idaho Department of Health and Welfare (the Department) has approved Prometric to administer its Certified Nurse Aide (CNA) Written (Knowledge) examination', and the Department's training overview lists the written test as 'Required to be placed on the Idaho CNA registry. IDHW approved vendor: Prometric.' Results flow back automatically — the vendor 'will send information on the candidate's successful completion of the Nurse Aide Competency Examination to the state's Nurse Aide Registry within two business days of the candidate passing the exam' — and 'Certificates are mailed from our contractor, Prometric, to the address listed on your renewal form.'",
   "training_hours": "120 clock hours minimum — 45 above the federal floor. The Department of Health and Welfare states the headline in its own FAQ: 'The CNA course is a NATCEP approved course that is 120 hours. This includes 80 hours of classroom instruction and 40 hours of clinical hand-on instruction.' The state curriculum breaks the same 120 down differently and in more detail, and both are official: 'The minimum total completion time for nursing assistant training in Idaho is one hundred twenty (120) hours. Of this: 1. The minimum time for classroom and laboratory work in the basic curriculum is eighty (80) hours. a. A minimum of forty (40) hours is required for laboratory/skills training. 2. The minimum amount of time required in a clinical facility is thirty-two (32) hours. a. A minimum of sixteen (16) hours must be completed at a nursing home, where an RN is on duty. An LPN may provide student supervision. b. Remaining sixteen (16) hours may be completed in a nursing home or hospital setting, where an RN is on duty. An LPN may provide student supervision. 3. The additional eight (8) hours may be classroom, laboratory or clinical setting, such as home health or hospice where an RN is on duty. An LPN may provide student supervision. 4. Assisted living facilities may not be used for clinical training.' The Department's own training-overview slides repeat that structure line for line. So the 80 is classroom and laboratory with at least half of it in the skills lab, the clinical requirement is 32 hours in an approved facility with at least half of that in a nursing home, and 8 hours float. The 16-HOUR pre-contact rule: 'At least sixteen (16) hours of classroom instruction shall be provided before direct involvement with a facility resident. The concepts and skills must include the following topics: communication, interpersonal skills, infection control, safety-emergency procedures, promoting residents' independence and respecting residents' rights.' On top of the hours sits a competence rule: 'Learners must not provide any services to residents for which they have not trained and been found proficient by the instructor', and every program 'must use a skills checklist to document students' performance of all skills taught in the program', a copy of which must be given to the student on completion. The curriculum is mandatory, not advisory: the Idaho Nursing Assistant Curriculum is organised into seventeen core modules from The Nursing Assistant in Holistic Care through Body Systems, and 'This curriculum must be used for all nursing assistant training in Idaho.'",
   "lapse_rule": "What ends an Idaho certificate is not working. The Department states the consequence without softening it: 'What if I cannot provide proof that I worked for 8 hours, or more, as a paid CNA within the two years preceding my certification expiring? You will need to retake the CNA exam and successfully complete both the written and skills tests. Contact the Idaho Nurse Aide Program to request an Approval to Test letter.' The candidate bulletin puts the same rule in the negative: 'If you have not worked for pay for a minimum of one, 8-hour day during the previous 24 consecutive months, your certificate will not be renewed. If you want to become certified again, you must retake both the Manual Skills Evaluation and Written Examination.' Retraining is not required — the bulletin's Route 5 exists precisely for this: 'A lapsed status means you were a CNA who did not meet the requirement of \"performing nursing-related duties for monetary compensation for at least one documented day for a period of 24 consecutive months.\" If you wish to become an active CNA again, you will be able to test without completing a training program. However, you must pass both the Manual Skills and Written exam.' Retraining is required for a different failure — exhausting the three attempts. On the skills side, 'If the manual skills test candidate is unsuccessful after three (3) attempts at the examination, he or she must successfully complete another nursing assistant program and successfully pass state testing to be placed on the Idaho Registry'; the written side carries the identical rule. The Department's own FAQ states the attempt limit plainly: 'How many times may I retest for the written or skills tests? You may retest up to three times for each test.' A late renewal is not penalised with a fee — Idaho charges nothing — but it can cost time: 'If you do not renew your certification within the requested timeframe, your recertification may be for less than two years', because the new expiry is calculated from the last day worked. Abuse findings are a separate and harsher track. A certificate carrying a substantiated finding can still be renewed but is stamped 'Prohibited to Work in a Medicare/Medicaid Facility under 42 CFR 483.156.' Only a neglect-only finding can be petitioned away: 'In the case of a validated finding of neglect only during an investigation of allegation(s) of resident neglect, abuse, and/or misappropriation of resident property, the nurse aide may petition the Registry to have his or her name removed from the registry', and only where the CNA abuse committee determines that 'The employment and personal history of the nurse aide does not reflect a pattern of abusive behavior or neglect' and 'The neglect involved in the original finding was a singular occurrence.' A decision 'cannot be made prior to the expiration of the one-year period beginning on the date on which the validated neglect was added to the Registry.'",
   "reciprocity": "Idaho grants reciprocity without an exam, and the condition turns on where you are going to work. The gate: 'Reciprocity is only granted when employment in Idaho has been offered or you are currently living in Idaho', and the Department warns that 'Incomplete, missing, and illegible information/documentation will result in an automatic denial of reciprocity.' The standard: the candidate bulletin describes it as deemed status — 'Nursing assistants who provide evidence of current status on any other state's NA Registry will be given deemed status, that is, they will be entered onto Idaho's NA Registry without having to take an examination.' What the form asks for: the state where the applicant is listed, the name under which they are listed, the registration number, date of birth and Social Security number; the nursing assistant training program completed, or one semester of nursing school; the competency examination date; and a full block for the Idaho employer — name, start date of hire, contact name, phone, email and address, with the note that 'Your employer will be notified of your eligibility to work in Idaho at the email listed above.' Required documents, all in PDF and with 'No screen shots or photos accepted': 'Submit a printed verification from your state's online Nurse Aide Registry stating you are active and in good standing (no negative findings)', plus either 'your Nurse Aide NATCEP course certificate' OR 'your transcripts showing you successfully completed 1 semester of nursing school.' Forms go to the same fax, email and postal address as renewals, and confirmation again depends on the channel: an emailed submission gets a reply, a faxed or posted one has to be checked on the registry site. Going the other way is not Idaho's job: 'You will need to contact the Nurse Aide Registry of the state you wish to transfer to and they will assist you with their transfer process. Some states do require a fee for transferring and there are different prerequisites in each state.' An older, broader waiver appears in the state-approved candidate bulletin and is recorded here as that document states it: 'Route 4—Waiver. Individuals who provide documentation of licensure as a nurse or physician from another state or country may be added to the registry without completing a CNA training course or testing. However, if any evidence exists of negative action on that license, the individual's application may be denied.' No corresponding statement appears on the Department's current pages, so this route is attributed to the bulletin rather than presented as current practice.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Idaho Department of Health and Welfare — About the Certified Nurse Assistant Registry (page last updated 4-9-2026). The program's home page and the single richest Idaho source. Establishes what the registry is and the employer duty to verify; the changes to verification (masked Social Security numbers, date of birth required, captcha); registry hours of operation; the CNA renewal, reciprocity and change-request forms; the scope-of-practice answer quoting the Board of Nursing's Unlicensed Assistive Personnel definition; the renewal rules including the eight-hour work test, the no-fee statement, the W-2 or pay-stub substitute, and the worked example showing that the new expiry is 24 months from the last day worked; the $15 duplicate certificate and replacement card fee; the reciprocity conditions; that 'The CNA course is a NATCEP approved course that is 120 hours. This includes 80 hours of classroom instruction and 40 hours of clinical hand-on instruction'; that 'Only nursing students can challenge the CNA exam' and that paramedics, EMTs, former military medics and medical assistants may not; the three-attempt retest limit; the one-year testing window and how to ask for more time; that certificates 'are mailed from our contractor, Prometric'; and the Idaho Nurse Aide Program contact details (1-800-748-2480, fax 208-334-6629, IDNAP@dhw.idaho.gov).\", \"url\": \"https://healthandwelfare.idaho.gov/providers/certified-nurse-assistant/about-certified-nurse-assistant-registry\"}, {\"label\": \"Idaho Department of Health and Welfare — Skilled Nursing Provider Resources (page last updated 7-22-2026). Establishes the federal frame ('The Nurse Aide Training and Competency Evaluation Program (NATCEP) in the state of Idaho follows the requirements as stated in federal regulations, 42 CFR Chapter IV Subchapter G Subpart D...'), the NATCEP application and instructor application, the skills checklists, testing resources and curriculum guide, the Department's copies of 42 C.F.R. 483.150 through 483.156, and the NATCEP FAQ answers on who may apply, that 'Facilities cannot train individuals from the community', the registered-nurse primary instructor requirement, the bar on the director of nursing serving as primary instructor, the two-year NATCEP ban rule, and the loss of approval on a change of ownership. Contact for training programs: (208) 334-6626, fsb@dhw.idaho.gov.\", \"url\": \"https://healthandwelfare.idaho.gov/providers/skilled-nursing/skilled-nursing-provider-resources\"}, {\"label\": \"Idaho Nursing Assistant 2021 Curriculum (Idaho Department of Health and Welfare / Idaho Division of Career Technical Education), published in the Department's public document repository. The state-approved curriculum every Idaho program must use. Establishes the hour requirements in full ('The minimum total completion time for nursing assistant training in Idaho is one hundred twenty (120) hours', 80 classroom and laboratory with at least 40 in the skills laboratory, 32 in a clinical facility with at least 16 at a nursing home, 8 flexible hours, and 'Assisted living facilities may NOT be used for clinical training'); the 16 hours of classroom instruction required before direct resident contact and the topics they must cover; the entry requirements (read, speak and write English, basic math) and the 80% course pass standard; the primary instructor and assisting instructor qualifications; the ten-students-per-instructor clinical ratio; the program administration rules; the manual skills testing rules (three attempts, six months, rater independence, testing at one of the six regional career-technical colleges or an approved registry-contractor site, extensions from the Department); the written testing rules (three attempts, one year, skills first, oral option for all students); the final skills checklist requirement; and the statement that a course completion certificate 'means only that the learner has successfully completed the nursing assistant course of study.'\", \"url\": \"https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=28194&dbid=0&repo=PUBLIC-DOCUMENTS\"}, {\"label\": \"Idaho Nurse Aide Training Overview (Idaho Department of Health and Welfare, Bureau of Facility Standards, published in the Department's public document repository). The Department's own summary of oversight and standards. Establishes the split of oversight between the Department and the Idaho Division of Career Technical Education; the basic curriculum requirements repeated hour by hour ('The minimum total completion time for NA training is 120 hours', 80 classroom and lab, 40 lab/skills, 32 clinical, 16 at a nursing home, 16 nursing home or hospital, 8 flexible, no assisted living); that 'At least 16 hours of classroom instruction must be provided before direct care'; that the Manual Skills Test is 'Provided by six career-technical colleges/universities' with raters employed by the colleges who 'must meet Primary Instructor requirements and attend annual training'; that the Written Test is 'Required to be placed on the Idaho CNA registry' with 'IDHW approved vendor: Prometric'; and the list of the six post-secondary programs plus the high school and Idaho Digital Learning Alliance programs.\", \"url\": \"https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=28195&dbid=0&repo=PUBLIC-DOCUMENTS\"}, {\"label\": \"Idaho Nurse Aide Renewal Form (revised 9.7.2023), published by the Department and mirrored on the state's testing contractor's Idaho page. Establishes the renewal instructions in the Department's own words: 'Send your renewal form in the SAME month of expiration date', 'You MUST work at least 8 hours as a PAID CNA in the two (2) years before your expiration date to be eligible to renew', 'Volunteer hours DO NOT count as hours towards renewing your certification', 'There is NO fee required to renew your CNA certification', the employer verification block for a 'CURRENT or MOST RECENT CNA, Home Health Aide, or Personal Care services EMPLOYER', the proof-of-payment requirement for personal care work, and the Registry's fax, email and postal addresses.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/ID_CNA_RenewalForm.pdf\"}, {\"label\": \"Idaho Reciprocity Form — Out of State Credential Verification (revised 9.07.2023), published by the Department and mirrored on the state's testing contractor's Idaho page. Establishes 'Reciprocity is only granted when employment in Idaho has been offered or you are currently living in Idaho'; the automatic-denial warning for incomplete or illegible submissions; the information required about the other state's registry listing; the Idaho employer block and the notice that the employer will be told of the applicant's eligibility; and the required documents — a printed verification from the other state's online registry showing active status and good standing with no negative findings, plus either the NATCEP course certificate or transcripts showing one semester of nursing school, all in PDF with 'No screen shots or photos accepted.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/ID_CNA_ReciprocityForm.pdf\"}, {\"label\": \"Candidate Information Bulletin — State of Idaho Certified Nurse Aide Examination (Rev. 20130426, published on the Idaho nurse aide page the Department links). Establishes that 'The Idaho Department of Health and Welfare (the Department) has approved Prometric to administer its Certified Nurse Aide (CNA) Written (Knowledge) examination'; the five eligibility routes (New Nurse Aide, Reciprocity, Challenger, Waiver, Lapsed) and the out-of-state training path; the six-month skills and one-year written deadlines and the three-attempt limit; the written exam format ('60 multiple-choice questions... 90 minutes') and the overall-score pass rule; the oral format; the English-only rule; the identification requirements and the Social Security number registry rule; the fee lines 'Written Exam $34 + testing site fees' and 'Oral Exam $34 + testing site fees' with 'Additional fees paid directly to the testing site will be required'; the rescheduling rules; the 60-day appeals window; the registry description and the neglect-only petition process with its one-year bar; the 24-month certificate term, the 45-day renewal reminder, the one-documented-day work rule, and the registry-card notation 'Prohibited to Work in a Medicare/Medicaid Facility under 42 CFR 483.156.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/ID_CNA_CIB.pdf\"}, {\"label\": \"Idaho Nurse Aide Testing Application (published on the Idaho nurse aide page the Department links). Establishes the live written-exam fee lines 'Written Exam $29' and 'Oral Exam $39', the warning that 'There may be additional test administration fees charged by the training program', the three testing routes offered on the form (New Nurse Aide, Reciprocity, Challenger), the training-program information required of Route 1 candidates, and the applicant's affidavit including 'I understand that I must have taken and passed the Manual Skills exam in order to be eligible to take the Written exam.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/ID_CNA_App.pdf\"}, {\"label\": \"Idaho nurse aide exam page (Prometric, the vendor the Department approved for the written examination and names as its registry contractor). The page publishing the Idaho candidate bulletin, the testing application, the renewal and reciprocity forms, the transfer application, the change request form, the written test content outline and the link to the Idaho registry lookup.\", \"url\": \"https://www.prometric.com/exams/nurseaide-id\"}, {\"label\": \"Idaho State Nurse Aide Registry public lookup (operated for the Department by its registry contractor, and linked from the Department's Certified Nurse Assistant Registry page). Establishes the three search modes — Social Security number with date of birth, certificate number, and name with date of birth — the employer-code option, and the notice that employers are required to search the registry before employing a nurse aide.\", \"url\": \"https://registry.prometric.com/registry/publicID\"}, {\"label\": \"Idaho Admin. Code 24.34.01 — Rules of the Idaho Board of Nursing (Division of Occupational and Professional Licenses), Subsection 002.31, dated 3-28-23. The source of the Unlicensed Assistive Personnel definition the Department of Health and Welfare quotes when explaining what an Idaho CNA may and may not do, including the prohibition on performing licensed nurse functions defined in Idaho Code 54-1402 and on being delegated acts requiring nursing assessment, diagnosis, care planning, teaching or nursing judgment.\", \"url\": \"https://adminrules.idaho.gov/rules/current/24/243401.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/id-cna/"
  },
  {
   "page_id": "il-cna",
   "state": "Illinois",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Illinois Department of Public Health — Health Care Worker Registry (the Department states the registry 'is maintained by the Department of Public Health'). No board of nursing is involved. The written competency examination is administered for the Department by Southern Illinois University Carbondale under the Illinois Nurse Assistant/Aide Competency Examination (INACE) project; the Department's own regulation reserves scoring to itself: 'A facility may proctor the examination but shall not score it. Scoring will be done only by the Department or its designee' (77 Ill. Adm. Code 395.400(a)(4)).",
   "board_url": "https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry.html",
   "application_url": "https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry/cna-facts.html",
   "renewal_cycle": "There is no renewal cycle, no expiry date and no renewal filing — and Illinois says so: 'CNA certification does not expire.' What replaces renewal is a continuous work test: 'a CNA will lose his/her active CNA certification status if he/she goes for a period of 24 consecutive months after his/her last competency evaluation without providing nursing or nursing-related services for pay under the supervision of a licensed nurse. To maintain an active CNA certification, a CNA must work at least one 8-hour shift within a 24-month period, performing nursing or nursing-related services for pay under the supervision of a licensed nurse. A CNA who continuously works in such a capacity will continue to retain an active CNA certification regardless of how many years that individual works.' The regulation states the same threshold as hours rather than shifts: not providing services 'for pay for at least eight hours (consecutive or non-consecutive) over a consecutive 24-month period' (77 Ill. Adm. Code 395.265(a)). Two traps the Department publishes itself. (1) Private duty does not count: 'For work history to count towards maintaining an active CNA certification, the CNA must be performing nursing or nursing-related duties for pay under the supervision of a licensed nurse. Private duty work does not meet that requirement.' (2) An 'Active' label on your registry profile is not proof your certification is active: 'A notation of \"Active\" next to your last employment verification does not necessarily mean that your CNA certification is still active. Our system looks to see if there is any work history or any employment verification added within the last 24 months—regardless of type of position; if so, it will indicate \"Active.\" An employer, however, is required to check all work history to ensure there is no gap of more than 24 months during which you did not perform nursing or nursing-related duties under the supervision of a licensed nurse. If there is such a gap, your CNA certification is not active.' Keeping the record straight is the employer's job, entered within 30 days of hire or termination and verified at least annually.",
   "ce_hours": "None is published as a condition of keeping CNA status. What Illinois requires instead of coursework is work — the eight-hours-in-24-months rule described under renewal. Checked and found to impose no continuing-education requirement on the individual CNA: 77 Ill. Adm. Code 395 in full (the Long-Term Care Assistants and Aides Training Programs Code, including Subpart A on program approval, 395.173 on successful completion, 395.265 on recertification, and Subpart C on the competency examination), the Department's Health Care Worker Registry page, its CNA Facts page, and its 'FAQs: CNAs & Other Workers' publication. Part 395 governs training programs and their instructors; it sets continuing requirements for approved instructors and evaluators, not for certified aides. Not searched, and named rather than assumed: 77 Ill. Adm. Code 300 (the Skilled Nursing and Intermediate Care Facilities Code) and the other facility-licensure Parts, which is where a facility-side in-service duty would sit if Illinois imposes one. So this page records the absence of an aide-side continuing-education requirement in the sources read, and makes no claim either way about an employer's in-service obligation.",
   "exam": "For CNA I the state examination is written only — the skills half happens inside the training program, not at a test centre, and this is the single most misunderstood fact about Illinois. The rule: 'The basic nursing assistant proficiency examination will be the Department-approved written competency examination developed from the curriculum outlined in Section 395.300', drawn 'from a pool of standardized written test questions, only a portion of which are used in any one examination', and 'available in both Spanish and English' (77 Ill. Adm. Code 395.400(a)). The language choice belongs to the candidate: 'It is the student's choice to take the exam in English or Spanish' (395.173(b)). The skills side is a program requirement — a student must have 'Demonstrated competence in the Department-approved performance skills' (395.173(a)(2)) — and the Department's own registry site describes the overall standard as 'a competency test covering 21 mandated manual skills and a written competency test.' Those 21 skills are listed by rule as the 'Approved Performance Skills' (395.50): wash hands; perform oral hygiene; shave a resident; perform nail care; perform perineal care; give a partial bath; give a shower or tub bath; make an occupied bed; dress a resident; transfer a resident to a wheelchair using a transfer belt; transfer a resident using a mechanical lift; help a resident to ambulate with a transfer belt; feed a resident; calculate intake and output; place a resident in a side-lying position; perform passive range of motion; apply and remove personal protective equipment; measure temperature, pulse and respiration; measure and record blood pressure; measure and record height; and measure and record weight. How it runs: the training program submits the graduate's information electronically to the INACE project, the candidate then verifies eligibility, creates an account and buys a seat; there are approximately 50 test sites across Illinois and the exam may be taken as a computer-based test subject to local availability. Who may sit it: 'An individual who has completed an approved Basic Nurse Assistant Training Program and who has met all other requirements of the HCWR may take the competency exam. Individuals placed on the HCWR based on reciprocity from another state are not required to take the Illinois written competency exam.' Results: the Department's FAQ says official INACE results appear on the registry 'approximately two weeks after testing' with a competency code (P = passed; F1, F2 for failures; NS for a no-show; R for reciprocity), while the INACE project says results for a recertifying CNA are 'posted to the Registry the Monday following the date of the competency test' — a difference the state does not reconcile. The CNA II examination is different again: it 'will be the Department-approved examination with written and performance skills components' (395.405(a)).",
   "fees": "Illinois charges no registry fee — there is no application fee to be listed as a CNA, because there is nothing to apply for once the program files your roster. The fees are examination fees, charged by the university that runs the examination, on a schedule effective July 1, 2023: Initial Exam Fee (12 Month Period) $85; Failed Exam Retake (within 12 months of program completion) $85; No-show Exam Reschedule (within 12 months of program completion) $55; Out-of-State CNA Application $25. 'NO REFUNDS OR EXCHANGES. All purchases are final.' Recertification is priced the same: 'Recertifications or qualifying exam with IDPH approval is the same fee schedule as above.' The regulation makes payment a precondition for a lapsed aide: 'Fees for the competency evaluation shall be paid before the lapsed nursing assistant may take the exam' (77 Ill. Adm. Code 395.265(c)). The reciprocity fee has a documented history and a payment rule that catches people out: IDPH's FAQ dates it 'Effective July 1, 2019', and the INACE page's live text states: 'As of July 1, 2023, a $25.00 fee has been instituted for the reciprocity process.' It cannot be paid electronically or by personal cheque: 'You will have to submit your application by mail along with a money order for $25.00 payable to SIUC or Nurse Aide Testing... Our office cannot accept a personal check or cash', and 'If you send in the application without the payment, it will be rejected.' Not set by the state: training tuition, which each approved program sets. The fee is stated by both sources: the Department's own CNA FAQ publication (revised August 2019) states the $25 transfer fee, and the INACE project's out-of-state application page states it as well — the two official sources agree on the fee. (A passage on the INACE page warning that IDPH's website might omit the fee exists only in hidden code in the page source — it is not displayed on the page and is not treated as published content here.) The fee is real and both official sources state it.",
   "legal_basis": "[{\"citation\": \"77 Ill. Adm. Code Part 395 — Long-Term Care Assistants and Aides Training Programs Code (Department of Public Health, Subchapter d: Long-Term Care Facilities). Implementing and authorized by the Nursing Home Care Act [210 ILCS 45], the ID/DD Community Care Act [210 ILCS 47], and the MC/DD Act [210 ILCS 46]\", \"what_it_governs\": \"The whole Illinois nursing assistant apparatus: program application and approval (Subpart A), the 120-hour minimum and its 62/18/40 split (395.150), the pre-enrolment fingerprint background check (395.171), what counts as successful completion (395.173), program non-compliance and revocation (395.190), the CNA II program and its 80/40 split (395.230), recertification after a lapse (395.265), the required curricula (Subpart B), the written competency examination and the three-attempts-in-12-months rule (395.400), the CNA II examination with written and performance components (395.405), and the Certified Nursing Assistant Intern Program (Subpart D). Most recently amended at 49 Ill. Reg. 4699, effective March 25, 2025, and at 48 Ill. Reg. 17753, effective December 2, 2024.\", \"url\": \"https://www.ilga.gov/agencies/JCAR/EntirePart?titlepart=07700395\"}, {\"citation\": \"Health Care Worker Background Check Act, 225 ILCS 46 — including Section 25 (disqualifying offences), Section 33(c) (the training-program check) and Section 40 (waivers)\", \"what_it_governs\": \"Who must be checked, which convictions disqualify, the waiver process that lets a disqualified person work anyway, and the employer's duty to verify registry status before employment. It reaches beyond CNAs to home health care aides, personal care assistants, private duty nurse aides, day training personnel and others providing direct care or holding access to long-term care residents and their records. Linked by the Department from both its Health Care Worker Registry and CNA Facts pages.\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry.html\"}, {\"citation\": \"77 Ill. Adm. Code Part 955 — Health Care Worker Background Check Code, including the disqualifying-offences section\", \"what_it_governs\": \"The administrative rules under the Health Care Worker Background Check Act, including the list of disqualifying offences the Department publishes separately. Cited by rule (77 Ill. Adm. Code 395.171 requires programs to comply with 'the Health Care Worker Background Check Act and the Health Care Worker Background Check Code') and linked by the Department as 'Disqualifying Offenses'. The part text was not read — the Illinois legislature's rules host could not be reached on 2026-08-14 and only Part 395 was retrieved through an alternate route, so this page states nothing specific about which offences disqualify.\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry/disqualifying-convictions.html\"}, {\"citation\": \"Department of Public Health Powers and Duties Law, 20 ILCS 2310 — Section 2310-434\", \"what_it_governs\": \"The statutory basis for the Certified Nursing Assistant Intern Program, quoted throughout 77 Ill. Adm. Code 395.500: the 8 hours of classroom education, the 24 hours of on-the-job training, the list of procedures an intern may perform, and the five procedures an intern may not.\", \"url\": \"https://www.ilga.gov/agencies/JCAR/EntirePart?titlepart=07700395\"}, {\"citation\": \"42 CFR Part 483, Subpart D — 42 CFR 483.151, 483.152 (including 483.152(b)(1)) and 483.156; and 42 CFR 483.75 on the facility side\", \"what_it_governs\": \"The federal frame: state approval of nurse aide training and competency evaluation programs, the 75-hour federal minimum and the 16 hours required before any direct resident contact, the state registry, and the four-month limit on using an untrained aide. Illinois cites 42 CFR 483.152(b)(1) inside 77 Ill. Adm. Code 395.150(a)(6), cites 42 CFR 483.151(b)(2)(i)-(v) as the compliance standard for approved programs in 395.190, and requires reciprocity applicants to document that '42 CFR, Sections 483.151 and 483.152' have been met.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Southern Illinois University Carbondale, running the Illinois Nurse Assistant/Aide Competency Examination (INACE) project for the Illinois Department of Public Health. The Department names it on its own CNA Facts page: 'Southern Illinois University at Carbondale (SIU-C) administers the written portion of the competency exam at various sites throughout the state... SIU-C transmits the test results to the registry electronically.' The project describes itself the same way: 'This information is provided in partnership with the Illinois Department of Public Health (IDPH) and Southern Illinois University Carbondale (SIUC), Illinois Nurse Assistant Competency Exam (INACE) project.' Scoring stays with the state: 'A facility may proctor the examination but shall not score it. Scoring will be done only by the Department or its designee' (77 Ill. Adm. Code 395.400(a)(4)).",
   "training_hours": "120 hours minimum for the Basic Nursing Assistant Training Program, split by rule into 62 theory + 18 laboratory (skills) + 40 clinical. The Illinois Administrative Code states it directly: 'Each program shall include a minimum of 120 hours of instruction, excluding breaks, meals, and any orientation to the program and clinical site', and 'The program shall include a minimum of 62 hours of theory instruction, 18 hours of laboratory (skills) instruction, and 40 hours of clinical instruction' (77 Ill. Adm. Code 395.150(a)(1) and (a)(3)). Four more hour rules sit inside that 120, and they are the part most summaries drop: a minimum of 12 hours of theory instruction on Alzheimer's disease and other dementias (395.150(a)(4)); a minimum of four hours of theory instruction in CPR, with students required to be CPR-certified before the program ends (395.150(a)(5)); and a minimum of 16 hours — covering communication and interpersonal skills, infection control, safety and emergency procedures including airway obstruction clearing, promoting residents' independence, and promoting residents' rights — 'which shall be conducted prior to any direct contact with a resident' (395.150(a)(6), citing 42 CFR 483.152(b)(1)). Calendar limits, not just hours: 'The basic program content shall be presented in a minimum time frame of four weeks, but cannot exceed 120 days, unless the training program is conducted by a community college or other educational institution on a term, semester, or trimester basis' (395.150(a)(2)) — so an Illinois BNATP cannot be compressed below four weeks. Failing the 120 hours is an enumerated ground for the Department to find a program non-compliant: 'The program does not satisfy the requirement of 120 hours of training' (395.190(b)(1)(H)). The CNA II route (ANATP) is a separate 120 hours at a different split — 80 theory/laboratory and 40 clinical practicum (395.230). Illinois is well above the federal floor: the federal minimum is 75 hours.",
   "lapse_rule": "Twenty-four consecutive months without at least eight hours of paid nursing or nursing-related work under a licensed nurse's supervision ends the certification. The regulation is blunt about the mechanism: 'If an individual who has previously been deemed competent as a CNA... has not provided nursing or nursing-related services for pay for at least eight hours (consecutive or non-consecutive) over a consecutive 24-month period, then the approved certification is revoked' (77 Ill. Adm. Code 395.265(a)). The Department's plain-language FAQ describes the same event more gently: 'your CNA certification will be shown as \"Inactive\" on the HCWR and you will be ineligible to work as a CNA until you have recertified.' Both are official; the word the reader sees on the registry is 'Inactive'. Getting back: 'A nursing assistant whose certification has lapsed... may apply to retake the written competency evaluation to reinstate certification. Fees for the competency evaluation shall be paid before the lapsed nursing assistant may take the exam' (395.265(c)) — no retraining is required first. In practice the lapsed CNA files the online recertification form with the university that runs the examination, then telephones to leave a name and Social Security number (the project states this second step is required to complete the process), and the office verifies the registry profile before submitting the candidate for testing. The same three-attempts-in-twelve-months rule then applies: 'The CNA will have one (1) year from the date they are submitted in the INACE program in which to take the CNA test and will have three (3) opportunities to pass the test within that time frame. If the CNA fails the competency test three (3) times, he or she must complete an Illinois approved CNA training program before taking the written test again.' A CNA II must climb back in order: 'A CNA II shall first recertify as a CNA I. Once a CNA I certification is valid, the CNA II competency evaluation test (certification exam) may be taken' (395.265(b)(2)). The state also offers a judgement rather than a rule for the long-absent: 'If the CNA has been out of the medical field for many years, he/she may benefit by completing an Illinois approved CNA training program and take the written competency test.'",
   "reciprocity": "Illinois grants reciprocity to an active out-of-state CNA and does not make them retest. Conditions, from the Department's CNA Facts page: the person must 'Have been deemed competent on another state's registry for CNAs'; 'Have documentation of current registration from another state indicating requirements listed in the Code of Federal Regulations (42 CFR, Sections 483.151 and 483.152) have been met'; 'Must have no administrative findings of abuse, neglect or misappropriations of property on their home state's CNA registry or any other state's CNA registry'; and 'Must have no disqualifying convictions on the home state's registry.' The Department's FAQ answers the obvious question outright: 'DO I NEED TO RETEST IF I TRANSFER MY CNA CERTIFICATION INTO ILLINOIS? No. Once you have been granted reciprocity status, you are eligible to seek employment in the State of Illinois as a CNA.' How it is filed — and it is the most paper-bound step in Illinois's whole process: the Out-of-State CNA Application must be mailed, with a $25 money order or cashier's cheque payable to SIUC or Nurse Aide Testing, to Illinois Nurse Aide Testing, Southern Illinois University Carbondale, 1840 Innovation Drive, Suite 103, Carbondale, IL 62903. No personal cheques, no cash, no online payment; an application arriving without payment 'will be rejected'. The check to do first: 'Before sending the application, check the registry for the state or states listed on your application to verify that you are an active CNA. If you are not active, your application cannot be processed.' On the registry your entry will read 'DEEMED COMPLETENT IN IL BASED ON ____ INFO' with competency code R. Going the other way: Illinois does not cancel your status when you leave — 'DO I LOSE MY ILLINOIS CERTIFICATION IF I TRANSFER TO ANOTHER STATE? No. To maintain your active CNA status, however, you must maintain active work status in Illinois' — which means the eight-hours-in-24-months rule must be satisfied by work IN Illinois. Illinois also confirms you may hold CNA status in more than one state at once.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Illinois Department of Public Health — Health Care Worker Registry. Establishes what the registry is and who maintains it, the scope of the Health Care Worker Background Check Act, the waiver requirement for disqualifying convictions, 'A health care employer must verify registry status of an individual applying for the above positions prior to employment', and 'Nursing assistants/aides working in licensed and or certified skilled nursing facilities, intermediate care facilities and home health agencies must be certified.'\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry.html\"}, {\"label\": \"Illinois Department of Public Health — CNA Facts. The single richest state source on this page. Establishes all six routes onto the registry, the licensed-nurse carve-out ('If a registered nurse (RN) or a licensed practical nurse (LPN) has a current, valid Illinois license and is in good standing, he or she can work as a CNA without being on the registry'), the out-of-state reciprocity conditions, the 24-month loss rule, 'Southern Illinois University at Carbondale (SIU-C) administers the written portion of the competency exam', the three-failures-then-retrain rule, the long-term-care employment conditions (age 16, temperate habits, English or a resident-understood language, eight years of grade school, two years of prior employment/residence evidence, 45 days into a program, 120 days onto the registry), the federal facility rules, 'the state does not issue credentials, certificates or license to CNAs', 'The information on the registry is the only means a health care employer may use to obtain this verification', and the employer's duty to enter and annually verify work history.\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry/cna-facts.html\"}, {\"label\": \"Illinois Department of Public Health — 'FREQUENTLY ASKED QUESTIONS: CNAs & Other Workers' (PDF, revised August 2019). Establishes 'There is no CNA certificate or license number for CNAs in Illinois. The State does not issue credentials, numbers, certificates, or licenses to CNAs', the instruction to write 'Not Applicable' when asked for a certificate number, 'CNA certification does not expire', the one-8-hour-shift-in-24-months maintenance rule, the private-duty exclusion, the warning that an 'Active' employment verification is not the same as active certification, the 30-day employer entry deadline and $500 fine, the transfer-in criteria and $25 fee, 'DO I NEED TO RETEST IF I TRANSFER MY CNA CERTIFICATION INTO ILLINOIS? No', the transfer-out procedure, the name-change procedure, who may sit the INACE, the two-week result timing and the P/F/NS/R competency codes, the registry-profile descriptions ('DEEMED COMPLETENT IN IL BASED ON ____ INFO', 'IDPH FUNDAMENTALS OF NURSING', 'IDPH FOREIGN LPN OR RN', 'IDPH MILITARY EQUIVALENT TRAINING', 'IDPH CERTIFICATION BY NACEP EXAM'), and the 45-day Illinois State Police turnaround.\", \"url\": \"https://dph.illinois.gov/content/dam/soi/en/web/idph/files/publications/faqs-cnas-other-workers-august-2019.pdf\"}, {\"label\": \"Illinois Department of Public Health Worker Registry — public site home page. Establishes 'Certification is achieved primarily by successfully completing a state-approved nursing assistant training program, a competency test covering 21 mandated manual skills and a written competency test', the acceptance of equivalencies with the note that equivalency candidates still take the written test, that all nursing assistants including home health aides must be listed, and that a facility must verify status before employment.\", \"url\": \"https://hcwrpub.dph.illinois.gov/\"}, {\"label\": \"Illinois Health Care Worker Registry — public search form. Establishes the search fields (Last Name required, First, Middle), the removal of Social Security number search and the on-profile SSN verification, and the Department's instruction to print and file the verified screen.\", \"url\": \"https://hcwrpub.dph.illinois.gov/Search.aspx\"}, {\"label\": \"77 Ill. Adm. Code Part 395 (Long-Term Care Assistants and Aides Training Programs Code), full Part text from the Illinois General Assembly's administrative code service. Establishes the 120-hour minimum and the 62/18/40 split, the 12-hour dementia and 4-hour CPR components, the 16 hours before direct resident contact, the four-week minimum and 120-day maximum, the definition of the 21 Approved Performance Skills, the pre-enrolment fingerprint background check and 3-month pending allowance, successful-completion requirements, the 120-hour non-compliance ground, the CNA II program's 80/40 split, the recertification rule, the written-only CNA I examination with its Spanish and English availability and the three-attempts-in-12-months limit, the CNA II examination's written-plus-performance components, and the Certified Nursing Assistant Intern Program's 8 classroom and 24 on-the-job hours with its permitted and prohibited procedures.\", \"url\": \"https://www.ilga.gov/agencies/JCAR/EntirePart?titlepart=07700395\"}, {\"label\": \"Illinois Nurse Aide Testing (INACE) — home page, the testing service the Department names on its CNA Facts page. Establishes that the information 'is provided in partnership with the Illinois Department of Public Health (IDPH) and Southern Illinois University Carbondale (SIUC), Illinois Nurse Assistant Competency Exam (INACE) project', the six paths to CNA status, and that military personnel and foreign-trained nurses are directed to the Health Care Worker Registry rather than to the testing project.\", \"url\": \"https://www.nurseaidetesting.com/\"}, {\"label\": \"Illinois Nurse Aide Testing — Fee Schedule (effective July 1, 2023). Establishes the $85 initial exam fee for a 12-month period, the $85 failed-exam retake, the $55 no-show reschedule, the $25 out-of-state CNA application, 'NO REFUNDS OR EXCHANGES', and that recertification uses the same schedule with the exam to be completed within 12 months of the program completion date.\", \"url\": \"https://nurseaidetesting.com/fee-schedule\"}, {\"label\": \"Illinois Nurse Aide Testing — Basic Nurse Assistant Training Program (BNATP). Establishes that the training program submits the graduate's information electronically to the INACE project, that there are approximately 50 test sites across Illinois with computer-based testing subject to availability, and '12 months from the program completion date in order to pass the Illinois Nurse Assistant/Aide Competency Exam. If you fail the exam three times, you must retake a CNA training program.'\", \"url\": \"https://www.nurseaidetesting.com/basic-nurse-assistant-training-program-bnatp/\"}, {\"label\": \"Illinois Nurse Aide Testing — Recertification Process. Establishes the online recertification form plus the required follow-up telephone call, the registry-profile review, the approximately 65 test sites available for recertification testing, the one-year/three-attempt limit, the retraining consequence of three failures, results posted 'the Monday following the date of the competency test', and the advice that a long-absent CNA 'may benefit by completing an Illinois approved CNA training program'.\", \"url\": \"https://www.nurseaidetesting.com/recertification-process/\"}, {\"label\": \"Illinois Nurse Aide Testing — Out-Of-State CNA Application. Establishes the $25 fee's reinstatement 'As of July 1, 2023', the mail-plus-money-order payment rule, the rejection of applications sent without payment, and the instruction to verify home-state active status first. (The page's source code also contains commented-out passages — a 2019 fee-introduction date, a COVID-era waiver, and a warning about IDPH's website — that render to no reader and are not cited as published content; the July 1, 2019 introduction of the $25 fee is published in IDPH's own FAQ.)\", \"url\": \"https://www.nurseaidetesting.com/out-of-state-cna-application/\"}, {\"label\": \"Illinois Department of Public Health — Disqualifying Convictions (the Department's own page for the offences that bar employment absent a waiver). Named here as the authoritative list; its contents are not reproduced on this page.\", \"url\": \"https://dph.illinois.gov/topics-services/health-care-regulation/health-care-worker-registry/disqualifying-convictions.html\"}]",
   "page_url": "https://licensingatlas.com/cna/il-cna/"
  },
  {
   "page_id": "in-cna",
   "state": "Indiana",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Indiana Department of Health (IDOH) — Aide Training, Certification, and Registry program, which maintains the Indiana Aides Registry. Determinations about who qualifies, who is renewed, and what the training curriculum must contain are made by a statutory body: the certified health care professions commission (IC 16-27.5-2-1), which the Department's own pages call the Certified Healthcare Professions Commission. The competency examination itself is administered by Ivy Tech Community College under the Department. Indiana's Board of Nursing licenses nurses and has no role in nurse aide certification.",
   "board_url": "https://www.in.gov/health/ltc/aide-training-and-certification/cna/",
   "application_url": "https://apps.ivytech.edu/apps/ext/cnaqma/",
   "renewal_cycle": "Every two years, free, and the test is work. IC 16-27.5-3-1(j): 'Certification under this section is valid for two (2) years. The state department may prescribe the manner in which to renew certification.' The Department states the work condition and the mechanism: 'To stay active as a CNA in Indiana, you must work at least eight hours in nursing-related duties every two years. Renewal is free and completed through MyLicenseOne; you may print your card here, too.' Notice is statutory, and so is the remedy if it is late: 'At least ninety (90) days before the date on which an individual's certification or registration under this article expires, the state department shall provide notice to the individual informing the individual of the expiration date and requirements for renewing' (IC 16-27.5-1-3(a)); and if that notice is late, an individual who renews 'not later than forty five (45) days after receiving the notice... may not be sanctioned for failing to renew the certification or registration on time' (IC 16-27.5-1-3(b)). A renewal can be held while a complaint is investigated: the Department may delay renewal for up to 120 days past expiry to investigate an allegation of abuse, neglect, misappropriation or misconduct, must notify the individual and open an investigation, and the commission must hold a hearing before the delay period ends; meanwhile 'An individual's certification or registration remains valid under this section until the earlier of: (1) the commission's determination...; or (2) the individual's application for renewal is denied', and if the commission fails to decide in time 'the state department shall renew the individual's certification or registration' (IC 16-27.5-1-4). Address changes are a legal duty, not a courtesy: 'A certified nurse aide shall notify the state department of any change in the certified nurse aide's mailing address or electronic mail address not later than thirty (30) days after the date on which the address changed' (IC 16-27.5-3-7), which the Department restates as 'It is your responsibility to update this information within 30 days of a name, address, phone, or email change.'",
   "ce_hours": "No continuing education course is required, but the statute and the Department describe the renewal condition differently and the difference matters. The Department names only work: 'To stay active as a CNA in Indiana, you must work at least eight hours in nursing-related duties every two years.' No course, no hour count, no provider list appears on any of the Department's nurse aide pages, and Ivy Tech's candidate FAQ repeats the Department's sentence verbatim. The statute adds a training condition the Department's pages do not mention: 'In order to renew a certification described in this section, a certified nurse aide shall complete the inservice training required under 42 CFR 483.95' (IC 16-27.5-3-1(k)). That federal section is the facility-side training requirement — the training a nursing home must provide its staff — so the practical effect for most aides is that the employer supplies it; but Indiana has written it into the renewal condition itself, which is not the same as the Pennsylvania-style position that in-service hours 'have no impact on registry renewal.' Both statements are Indiana's own and this page states both rather than choosing. For contrast, the Qualified Medication Aide credential on the same registry does carry a plain course requirement: 'Each two-year renewal period requires that QMAs complete six hours of medication-related training to maintain their certification. An additional hour is required if the QMA is insulin-certified.'",
   "exam": "Two parts, both required. The Department: 'To become a CNA in Indiana, you must first complete a 75-hour training program. After completing the training program, you must complete and pass a written test and a skills test.' Written: 'The written test includes 100 multiple-choice questions and must be completed with a score of at least 80 correct answers (80%); up to four attempts of the written test are allowed within a two-year period.' Ivy Tech adds the time and the language option: '90 minutes allowed for the written exam', 'You may miss no more than 20 questions for a passing grade of 80%', and 'the written test is available in Spanish. When scheduling, choose the exam name \"CNA Certified Nurse Aide Written Exam Spanish Version\".' Skills: 'The skills test requires the demonstration of proper hand hygiene, initial and final steps, and four skills that are selected at random; competency must be demonstrated to an evaluator. Up to four attempts of the skills test are allowed within a two-year period.' Ivy Tech states that 'The skills exam is untimed.' Where: 'You can take your CNA skills test at your training program... You can also ask to take the skills test at a Community Day event held at your local Ivy Tech campus', while the written exam is taken at an Ivy Tech testing centre of the candidate's choosing. Results: same day. 'Tests are scored at the testing site', 'Candidates receive test results at the test site on the day of testing', 'Test results are not revealed by phone', and 'If the candidate does not pass, documentation will be provided to the candidate stating the test(s) to be retaken and areas of needed study.' Attempts — a difference between the two official statements, recorded both ways. The Department's page applies the four-attempt limit to each test without qualification. The statute applies it only to some routes: 'An individual described in subsection (b), (c), or (f) may take the state nurse aide competency examination not more than four (4) times in a two (2) year period' — that is, the nursing-student, graduate-nurse and military routes — 'If the individual does not pass the state nurse aide competency examination after four (4) attempts in a two (2) year period, the individual must personally appear before the commission before reapplying for certification' (IC 16-27.5-3-1(h)). Ivy Tech states the general rule the way the Department does: 'You have four (4) chances to test for CNA or QMA', and 'The Certified Health Care Professions Commission requires that any CNA or QMA candidate that does not successfully complete testing within four (4) attempts in a two (2) year period must personally appear before the commission before reapplying for certification.' After the exam: 'Once Ivy Tech has submitted the results to the Dept. of Health, allow 8 to 10 weeks to receive your license in the mail. It could take up to 30 days to be added to the Registry.' A change now in force: Ivy Tech publishes that 'Beginning 9/1/26, Emergency Medical Responder and Psychiatric Attendant CNA candidates will be required to take both the written and skills portions of the exam'. That date arrived on September 1, 2026, and the wording at the source was unchanged when checked again on 2026-09-01, so both portions are now required for those routes. The two Ivy Tech documents diverge on who is covered, and both are recorded: the Process Changes document names only Emergency Medical Responder and Psychiatric Attendant, while the Application Information document marks a third route, Military Health Care Experience, '(skills testing required effective 9/1/26)'. Indiana's Department of Health states the written-and-skills requirement for Emergency Medical Responder and Military Healthcare Experience without naming any date.",
   "fees": "Indiana charges no state application fee and no renewal fee. The Department states the renewal side flatly: 'Renewal is free and completed through MyLicenseOne.' No certification, registry-entry or card fee appears on any of the Department's nurse aide pages. What you do pay is the examination, and it is paid to Ivy Tech: 'Effective January 1, 2025, the fee structure for testing at Ivy Tech Community College Testing Services will be as follows: CNA Combined Written & Skills Exam - $100; CNA Written Only or Skills Only - $90; QMA - $90; QMA-Insulin - $75; Home Health Aide-Tube Feeding - $75.' Ivy Tech explains the rise in its own words: 'Fees for testing have remained the same for several years and the increase is necessary to cover program costs.' Reciprocity is a flat application charge, not an exam charge: 'CNA or QMA Out-of-State Reciprocity - $50 if you applied after 9/1/25. Note - An application is required but candidates will not need to test after 9/1/25.' Retests are full price: 'You must submit a new payment for each time you retest' — $100 for both sections, $90 for one. No-show charges: 'No show for written exam appointment $15'; 'No show for skills exam appointment $90'; and the skills no-show fee is paid on a different Ivy Tech site from the application. Payment and refund rules: 'All payments are made online during application submission and will only be done by credit/debit card', 'Invoicing is not available', 'You must cancel at least 48 hours before your test date. If you cancel late, you will have to pay the testing fee again', and 'Your payment is good for 90 days. You must either take your test or request a refund within those 90 days.' Not set by the state: training tuition. The Department publishes an approved-program list by county and city but no price; neither the Department nor Ivy Tech publishes a tuition figure, and no Indiana source we checked states who bears the cost of Indiana nurse aide training.",
   "legal_basis": "[{\"citation\": \"Ind. Code art. 16-27.5 (Aide Certification and Registry), added by P.L.143-2025, SEC.24; ch. 1 Administration, ch. 2 Certified Health Care Professions Commission, ch. 3 Certification of Nurse Aides, ch. 4 Certification of Qualified Medication Aides, ch. 5 Home Health Aides\", \"what_it_governs\": \"The whole of Indiana's aide credentialing scheme as it now stands: the registry duty under 42 CFR 483.156, the investigation and finding procedure, the 90-day expiration notice and the 45-day protection when it is late, the 120-day renewal hold during an investigation, the one-year application forfeiture, the commission's membership and its power to decide qualifications and curriculum, the six routes to nurse aide certification, the two-year certification term, the four-attempt limit, the 75-hour training requirement, the 60-day enrolment rule for newly hired aides, reinstatement after a lapse, instructor certification, the 30-day address-change duty, and the title-protection offence.\", \"url\": \"https://iga.in.gov/ic/2026/Title_16.html\"}, {\"citation\": \"Ind. Code 16-27.5-3-1 (Certification of nurse aides; requirements; exceptions; competency examination attempts; renewal)\", \"what_it_governs\": \"The six qualifying routes and what each requires, the application contents, the perjury affidavit about IC 16-28-13-3 crimes, the employer's duty to obtain a limited criminal history from the state police, the four-attempt limit for the nursing-student, graduate-nurse and military routes, the two-year certification term, and the renewal condition tied to 42 CFR 483.95 in-service training.\", \"url\": \"https://iga.in.gov/ic/2026/Title_16.html\"}, {\"citation\": \"Ind. Code 16-27.5-3-4 (Nurse aide training program; application; requirements; revocation of approval)\", \"what_it_governs\": \"The statutory training floor: 'A nurse aide training program must include seventy-five (75) hours of training, a majority of which are supervised clinical experiences. At least sixteen (16) hours of the supervised clinical experiences must be supervised practical training.'\", \"url\": \"https://iga.in.gov/ic/2026/Title_16.html\"}, {\"citation\": \"Ind. Code 16-28-13-3 (Crimes barring employment at certain health care facilities), as amended by P.L.89-2025, P.L.171-2025, P.L.186-2025, P.L.23-2026 and P.L.85-2026\", \"what_it_governs\": \"The conviction list a nurse aide applicant must swear they are clear of, the look-back periods that apply to some of those offences, the peer-recovery-coach exception on controlled-substance felonies, the bar on anyone with a registry finding of abuse, neglect, mistreatment or misappropriation, and the Class A infraction for applying after a disqualifying conviction.\", \"url\": \"https://iga.in.gov/ic/2026/Title_16.html\"}, {\"citation\": \"42 CFR Part 483, Subpart D — 42 CFR 483.151, 483.152, 483.156, and the facility-side 42 CFR 483.95\", \"what_it_governs\": \"The federal frame Indiana's scheme sits inside: state approval of nurse aide training and competency evaluation programs, the instructor requirements the statute imports by reference, the state registry and the 24-month lapse rule, and the in-service training Indiana has written into its own renewal condition. The Department names 42 CFR 483.151 among the laws and regulations governing its training programs.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"410 Ind. Admin. Code 16.2 (Health Facilities; Licensing and Operational Standards)\", \"what_it_governs\": \"The Department names this article, alongside IC 16-27.5-4 and 42 CFR 483.151, as controlling authority for nurse aide training programs. Its text is not quoted anywhere on this page. Indiana's administrative rules site would not deliver the article text as of August 16, 2026 — every address tried returned an application shell with no rule text in it — so nothing here rests on the article, and where the Department's guidance and the statute differ, this page reports both rather than resolving the difference against a rule it could not read.\", \"url\": \"https://iar.iga.in.gov/code/current/410/16.2\"}]",
   "exam_vendor": "Ivy Tech Community College — Indiana's statewide community college, acting for the Department of Health, not a national testing company. The Department: 'Testing locations are offered throughout the state and scheduled through Ivy Tech Community College (ITCC).' Ivy Tech: 'Ivy Tech Community College (Ivy Tech) administers Nurse Aide Competency (CNA) and Qualified Medication Aide (QMA) certification exams for qualified candidates in compliance with Indiana Department of Health (IDOH).' Indiana therefore does not use the NNAAP, Prometric or a private vendor for the nurse aide competency evaluation, and Ivy Tech states that the content is Indiana's own: 'Test questions and skills evaluations are developed directly from the Indiana State Department of Health approved Resident Care Procedures and Course Content Standards.' Applications and payments run through Ivy Tech's own portal; the Department's own page routes the candidate there with a 'Click to Start Your Application' link.",
   "training_hours": "75 hours minimum, and Indiana breaks it down two different ways in two official places — both are reproduced here because they are not identical. The statute: 'A nurse aide training program must include seventy-five (75) hours of training, a majority of which are supervised clinical experiences. At least sixteen (16) hours of the supervised clinical experiences must be supervised practical training' (IC 16-27.5-3-4(b)). The Department's program page: 'Each NAT program must consist of a minimum of 75 hours; this format includes a minimum of 30 hours of classroom instruction and a minimum of 45 hours of clinical instruction. Of the 45 clinical hours, up to 21 may be completed in a laboratory setting and at least 24 hours must be completed in a licensed comprehensive long-term care (LTC) facility.' The two reconcile on the total and on 'a majority... supervised clinical' (45 of 75), but the Department's floor of 24 hours inside a licensed comprehensive long-term care facility is stricter and more specific than the statute's 16 hours of supervised practical training, and the reader is owed both numbers rather than a blend. The hours recently changed, and the Department says so: 'Previous guidelines allowed up to 20 hours of clinical instruction to be completed in an approved licensed assisted living (AL) facility; however, this option is no longer available due to the reduced total number of clinical hours.' Ivy Tech's candidate material still accepts either vintage for testing eligibility — 'Must have successfully completed a 75 or 105 hour state approved program' — so a 105-hour Indiana certificate remains valid for the examination. The Department also fixes the wording that must appear on a completion certificate: that the student 'has successfully completed the Indiana Department of Health's (minimum of) 75-hour Nurse Aide Training Program.' Programs may exceed the floor: 'these requirements reflect the minimum number of hours. Training entities are always permitted to exceed these standards to best support student learning and competency.' The Department publishes its own Indiana Nurse Aide Training Curriculum in 30 lessons plus 72 resident care procedures, and states that all programs 'are expected to utilize the Indiana Nurse Aide Training Curriculum, which establishes the minimum course standards.'",
   "lapse_rule": "An expired certification is an employment bar, not a grace period. The Department's registry status list: 'A status of expired means that the aide is ineligible to be employed until they renew their certification.' The underlying federal rule is the 24-month one: a certification lapses out of the registry where the aide has not performed nursing or nursing-related services for at least 24 consecutive months (42 CFR 483.156). Getting back on, in Indiana's own words: 'A nurse aide who: (1) was removed from the nurse aide registry established under IC 16-27.5-1 in the previous five (5) years due to not performing any nursing or nursing related services for at least twenty-four (24) consecutive months under 42 CFR 483.156; and (2) has had no findings of abuse, neglect, or misappropriation of patient property while certified; may be reinstated to the registry following the successful passage of the state nurse aide examination' (IC 16-27.5-3-3(b)). Two limits are worth reading twice: the five-year window — beyond it, the statute provides no reinstatement-by-examination route — and the clean-record condition, because a finding closes the route entirely. A separate and harsher status is 'FINDING': 'A status of finding means that the aide is prohibited from working as a CNA, QMA, or HHA.' A finding is placed only on the commission's direction — the Department 'may only place a finding of abuse, neglect, misappropriation, or misconduct... in the registry as directed by the commission' (IC 16-27.5-1-2(c)) — after the Department investigates and presents evidence, and the individual is entitled to 'provide an oral or written statement to the commission concerning the evidence' (IC 16-27.5-2-4(b)). The commission may also act against a certification if the individual 'fails to appear at a hearing before the commission, as required by the commission' (IC 16-27.5-1-5). No Indiana source we checked publishes a route to remove a finding once entered.",
   "reciprocity": "Indiana calls it reciprocity, and since September 1, 2025 it no longer requires a test. The Department's conditions: 'Must be currently certified as a CNA in another state' and 'Certification must be active, in good standing, with no verified complaints or disciplinary action.' The statute puts it the same way: an out-of-state nurse aide 'or the equivalent' must apply as prescribed and 'Submit proof that the applicant is a nurse aide in good standing with no verified complaints in another state or criminal convictions since becoming certified in the other state', plus the IC 16-28-13-3 affidavit (IC 16-27.5-3-1(d)). Ivy Tech states the change and the price: 'Beginning on 9/1/25, Reciprocity candidates will not need to test. They must apply and pay the $50 application fee', and for anyone caught mid-process, 'If you applied before 9/1/2025, your application will now be requesting an additional document. You will need to upload the Affidavit listed above... You will NOT need to test!' The affidavit is paper: it 'must contain a \"wet\" signature and cannot be electronically signed.' What you must send: 'Copy of current out-of-state CNA certification which shows the registry number and expiration date.' Three states get an extra step, and it is the detail most transfers are refused over: 'if a CNA from Illinois, Nebraska or Alabama has been licensed as a CNA for more than two years, they are also required to submit a letter from their employer, in that state, which indicates they have worked at least one eight hour shift in the past 24 months' — on company letterhead, naming the candidate, the work title, the dates of employment, an explicit statement of the eight hours in the last 24 months, and the employer's signature, title and contact email. 'A paystub or offer of employment does not meet the requirement.' Employers documenting an out-of-state candidate must also include 'a completed Out-of-State Validation Statement on facility letterhead, signed by the facility representative who contacted the appropriate out-of-state registry.' While you wait, you may work: 'You can work for 120 days from the date of hire before you are required to be certified in Indiana.'",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Indiana Department of Health — Certified Nurse Aide (CNA) Training and Certification (the programme landing page; page states 'Last Updated: Mar. 9, 2026'). Establishes 'The Certified Nurse Aide (CNA) Training and Certification Program at the Indiana Department of Health (IDOH) is designed to ensure that individuals meet both state and federal requirements to work as CNAs in Indiana. All qualified CNAs must be listed on the Indiana Aides Registry', the supervision rule ('CNAs perform their duties under the supervision of a licensed practical nurse (LPN) or registered nurse (RN), and must operate strictly within the scope of practice defined for CNAs'), and the three separate contact addresses for training, registry and investigations.\", \"url\": \"https://www.in.gov/health/ltc/aide-training-and-certification/cna/\"}, {\"label\": \"Indiana Department of Health — Training, Certification, and Recertification (page states 'Last Updated: Jun. 26, 2026'). Establishes the six qualifying routes, 'Complete a state-approved nurse aide training (NAT) program consisting of a minimum of 75 hours', 'No age requirement', 'Must be able to complete simple mathematical equations (adding/subtracting) and read and write in English', the written test ('100 multiple-choice questions and must be completed with a score of at least 80 correct answers (80%); up to four attempts... within a two-year period'), the skills test ('proper hand hygiene, initial and final steps, and four skills that are selected at random'), 'Testing locations are offered throughout the state and scheduled through Ivy Tech Community College (ITCC)', the renewal rule ('you must work at least eight hours in nursing-related duties every two years. Renewal is free and completed through MyLicenseOne'), the 30-day contact-update duty, the registry statuses active/expired/finding, and the Certified Healthcare Professions Commission's composition and duties.\", \"url\": \"https://www.in.gov/health/ltc/aide-training-and-certification/cna/training-certification-and-recertification/\"}, {\"label\": \"Indiana Department of Health — Training Programs (page states 'Last Updated: July 13, 2026'). Establishes the hour breakdown ('Each NAT program must consist of a minimum of 75 hours; this format includes a minimum of 30 hours of classroom instruction and a minimum of 45 hours of clinical instruction. Of the 45 clinical hours, up to 21 may be completed in a laboratory setting and at least 24 hours must be completed in a licensed comprehensive long-term care (LTC) facility'), the withdrawal of the assisted-living clinical option ('this option is no longer available due to the reduced total number of clinical hours'), the required completion-certificate wording, the Train-the-Trainer requirement for program directors and delegated instructors, the Indiana Nurse Aide Training Curriculum in 30 lessons plus 72 resident care procedures, and the laws-and-regulations list naming IC 16-27.5-4, 410 IAC 16.2 and 42 CFR 483.151.\", \"url\": \"https://www.in.gov/health/ltc/aide-training-and-certification/cna/training-programs/\"}, {\"label\": \"Indiana Department of Health — Aide Training, Certification, and Registry (the parent page for all three aide credentials). Establishes 'IDOH manages the official registries for certified nurse aides (CNAs), home health aides (HHAs) and qualified medication aides (QMAs)', 'Those who want to work in a licensed nursing home, home health agency, or hospice must be listed (by name) in the aides registry', the employer's pre-hire duty to check the registry, the three-step summary of becoming a CNA, and the definitions of dining assistant ('must successfully complete a 16-hour training program'), home health aide (agency competency evaluation plus training meeting 42 CFR 484.80) and QMA.\", \"url\": \"https://www.in.gov/health/ltc/aide-training-and-certification/\"}, {\"label\": \"Indiana Department of Health — Qualified Medication Aide (QMA) Training and Certification. Establishes the CNA-first rule and the QMA renewal education requirement ('Each two-year renewal period requires that QMAs complete six hours of medication-related training to maintain their certification. An additional hour is required if the QMA is insulin-certified'), the 18-and-diploma floor, the 1,000-hour CNA work prerequisite and the commission waiver, and the 100-hour QMA training minimum — used here only to draw the boundary between the two credentials.\", \"url\": \"https://www.in.gov/health/ltc/aide-training-and-certification/qma/\"}, {\"label\": \"Indiana Code, 2026 edition, Title 16 (Health), static full-text export from the Indiana General Assembly. Establishes the entire text of art. 16-27.5 quoted on this page — the registry duty, the commission and its powers, the six certification routes, the perjury affidavit, the four-attempt limit, the two-year term, the 75-hour training floor with 'a majority of which are supervised clinical experiences' and 'At least sixteen (16) hours... supervised practical training', the 60-day enrolment rule for newly hired aides, reinstatement after a 24-month lapse, the 30-day address-change duty, and the CNA title-protection offence — together with IC 16-28-13-3's list of crimes barring employment.\", \"url\": \"https://iga.in.gov/ic/2026/Title_16.html\"}, {\"label\": \"Ivy Tech Community College — CNA, QMA, Home Health Aide Testing Information (the page the Department of Health links as 'Click to Start Your Application'). It carries no text of its own: it is a set of links to Google Docs in which Ivy Tech publishes the candidate instructions, fee structure, FAQ and route-by-route requirements.\", \"url\": \"https://www.ivytech.edu/student-services/support-services/testing-services/cna-qma-home-health-aide-testing-information\"}, {\"label\": \"Ivy Tech Community College — CNA/QMA Testing Office Process Changes and Updates. Establishes the fee table effective January 1, 2025 ('CNA Combined Written & Skills Exam - $100; CNA Written Only or Skills Only - $90'), the reason given for the increase, the September 1, 2025 change that 'Reciprocity candidates will not need to test. They must apply and pay the $50 application fee', and the change, in force since September 1, 2026, that 'Beginning 9/1/26, Emergency Medical Responder and Psychiatric Attendant CNA candidates will be required to take both the written and skills portions of the exam.'\", \"url\": \"https://docs.google.com/document/d/1HgnF8tl9jkAMA1YY2Ziy19r6NblLZ3dGtnId5XmPep4/edit\"}, {\"label\": \"Ivy Tech Community College — Certified Nurse Aide: Application Information. Establishes 'Ivy Tech Community College (Ivy Tech) administers Nurse Aide Competency (CNA) and Qualified Medication Aide (QMA) certification exams for qualified candidates in compliance with Indiana Department of Health (IDOH)', and the list of eligible application types with their effective-dated changes.\", \"url\": \"https://docs.google.com/document/d/1iSutkOxUDZJV_1xpSIjSWPp5t3SI-YJcGUsS5IgFxiY/edit\"}, {\"label\": \"Ivy Tech Community College — Completed Indiana Training Course CNA. Establishes 'Must have successfully completed a 75 or 105 hour state approved program', 'No age or education requirements', 'Testing: Must take both the written and skills portions of the test', and that the application and card payment are made at apps.ivytech.edu.\", \"url\": \"https://docs.google.com/document/d/1gzAxPH8RuPa9hK-FUoxcwTljZQ8s5U9gmQn86BYTHX8/edit\"}, {\"label\": \"Ivy Tech Community College — CNA In Another State (Reciprocity). Establishes the September 1, 2025 conditions ('Must be currently on the nurse aide registry in another state with no verified complaints'; 'Testing: No testing required'; 'Application processing fee: $50'), the wet-signature affidavit rule, the required copy of the out-of-state certification showing registry number and expiration date, the Illinois/Nebraska/Alabama employment-letter requirement and its eight fields, 'A paystub or offer of employment does not meet the requirement', and the Out-of-State Validation Statement employers must complete.\", \"url\": \"https://docs.google.com/document/d/1KUlWoNclQJfj8EHZGHtuErxvtcJmre3tiA9pR5uXyUk/edit\"}, {\"label\": \"Ivy Tech Community College — Testing Scoring. Establishes 'Test questions and skills evaluations are developed directly from the Indiana State Department of Health approved Resident Care Procedures and Course Content Standards', same-day results at the test site, 'Test results are not revealed by phone', and the fail documentation naming the tests to be retaken.\", \"url\": \"https://docs.google.com/document/d/1Ru914BGedhdts7ACzgGZb1KnV7gq1zsexyVWcaghegk/edit\"}, {\"label\": \"Ivy Tech Community College — CNA/QMA Frequently Asked Questions. Establishes the exam length ('90 minutes allowed for the written exam. The skills exam is untimed'), the 100-question count and 'You may miss no more than 20 questions for a passing grade of 80%', the Spanish written version, the four-attempt rule and the requirement to appear before the commission after four failures in two years, the two-year post-training testing window and its start point, 'You must retake the CNA training course over again' if it is missed, the 120-day working allowance, the no-show fees ($15 written, $90 skills), the 48-hour cancellation rule, the 90-day validity of a payment, 'allow 8 to 10 weeks to receive your license in the mail. It could take up to 30 days to be added to the Registry', and the renewal answer that repeats the Department's eight-hours-in-two-years rule.\", \"url\": \"https://docs.google.com/document/d/1qNWENC4i9w3VUU2Kiiw3K1GSqXP_CXmyeU9Ost8yQ1A/edit\"}, {\"label\": \"Ivy Tech Community College — CNA/QMA/HHA online application portal, the address Ivy Tech's own instructions give for filing and paying for the Indiana nurse aide competency evaluation and for requesting a retake.\", \"url\": \"https://apps.ivytech.edu/apps/ext/cnaqma/\"}, {\"label\": \"Indiana Department of Health — Certified Nurse Aide Training Site Reports (the approved-program list, published by county and city). The Department notes that 'the reports are updated the first week of every month and the data presented is aged approximately one month before being published.'\", \"url\": \"https://www.in.gov/health/reports/QAMIS/nat/index.htm\"}, {\"label\": \"Indiana Aides Registry public lookup, linked by the Department of Health as 'Click for Indiana Aides Registry' and by Ivy Tech's FAQ as the place to find a CNA or QMA number.\", \"url\": \"https://mylicense.in.gov/eVerification/\"}]",
   "page_url": "https://licensingatlas.com/cna/in-cna/"
  },
  {
   "page_id": "ks-cna",
   "state": "Kansas",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Kansas Department for Aging and Disability Services (KDADS) — Health Occupations Credentialing (HOC), inside the agency's Survey, Certification and Credentialing Commission. HOC certifies nurse aides, approves the training courses and the instructors, prescribes and gives the state examination, and maintains the Kansas Nurse Aide Registry. Its office is at 503 S Kansas Ave., Topeka, KS 66603-3404. The Kansas State Board of Nursing licenses nurses and has no role in nurse aide certification.",
   "board_url": "https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing",
   "application_url": "https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/applications-forms",
   "renewal_cycle": "Kansas publishes no renewal term and no renewal fee for a certified nurse aide, and the absence is not an oversight of this page — it is what the state's own pages show. KDADS's Licensure page carries an 'Online License Renewal' section with the opening dates for every credential it renews: 'Dietitian: January 15; Operators: March 15; Adult Care Home Administrators: May 15; Speech-Language Pathologists: September 15; Audiologists: September 15.' Nurse aides are not on that list. K.S.A. 39-936 contains no expiry, no term of years and no renewal provision for the certification. What Kansas uses instead is a refresher trigger tied to not working: an adult care home must require a certified nurse aide to complete an approved refresher course where the aide 'since passing the examination required under paragraph (2), has had a continuous period of 24 consecutive months when the certified nurse aide has not provided direct, individual care to residents' (K.S.A. 39-936(c)(8)(A)), and 'The secretary for aging and disability services shall prepare guidelines for the preparation and administration of refresher courses and shall approve or disapprove courses' (39-936(c)(8)(B)). The other recurring obligation is the employer's, on every hire: a facility may not use a certified nurse aide 'unless the facility has inquired of the state registry as to information contained in the registry concerning the individual' (39-936(c)(7)). KDADS also publishes a 'Name or Address Change Certification' form for keeping the registry entry current. Anyone who needs a definitive statement of whether a Kansas certification lapses on a date should ask Health Occupations Credentialing directly — the agency routes 'Nurse Aide Registry General Questions' to a named staff member at 785-296-6877.",
   "ce_hours": "No continuing education requirement for a certified nurse aide is published in any Kansas source we checked. The sources searched were K.S.A. 39-936 in full, K.S.A. 39-970, K.S.A. 39-979, and every readable KDADS Health Occupations Credentialing page including the Licensure page and the All Training Courses / Continuing Education page. That last page is the strongest evidence: it sets out continuing-education material credential by credential — 'ACHA CE Methods', 'Dietitian CE Methods', 'Operator CE Methods', 'SLP AUD CE Methods', each with a prorated CEU schedule — and it lists nothing of the kind for nurse aides. What the same page does list under the nurse aide heading is the refresher and the medication-aide update: 'CNA - 90-Hour; CNA Refresher; CMA Update; CMA - 75-Hour'. So the recurring education obligation Kansas actually publishes for this credential is the refresher course triggered by 24 consecutive months without providing direct, individual care (K.S.A. 39-936(c)(8)), not an annual or biennial hour count. The certified medication aide, by contrast, has a Continuing Education Renewal Application Form and a Continuing Education Instructor Roster among KDADS's published documents — a useful contrast, and a reason not to import the medication aide's rules onto the nurse aide.",
   "exam": "An examination is required, and the course is not. That combination is the distinctive Kansas fact. The examination is 'prescribed by the secretary for aging and disability services' and must be 'the same examination' for every candidate (K.S.A. 39-936(c)(4)), but the statute forbids KDADS from tying it to a particular course: 'The licensing agency shall not require unlicensed employees... to enroll in any particular approved course of instruction as a condition to the taking of an examination' (39-936(c)(3)). What KDADS may do instead is approve or disapprove courses and publish guidelines for them. Anyone who completes an approved course 'shall be eligible to take an examination' (39-936(c)(4)), and KDADS supports the alternative route with a 'Documentation of Training for Challenging Test' form. Practical machinery KDADS publishes: a list of test sites for nurse aide and home health aide exams, a rescheduling request form, and an accommodation request form for the state exam. What this page does not state, because Kansas did not publish it where it could be read: the number of questions, the time allowed, the passing score, the number of attempts permitted, and whether the skills portion is separately scored. Those are set by the secretary's rules and by the candidate materials; the KDADS document titled 'Certified Nurse Aide Regulations' and the agency's certification FAQ page could not be opened as of August 16, 2026, and Kansas's administrative regulations site would not deliver rule text. No figure is guessed here. There is one structural signal worth recording from the statute's neighbouring track: for the non-CNA competency route, 'such unlicensed employees shall demonstrate competency in a list of skills that are identified and prescribed by the secretary for aging and disability services', evaluated by a qualified registered nurse (K.S.A. 39-936(c)(2)(B)) — so Kansas's competency standard is a state-prescribed skills list rather than a vendor's.",
   "fees": "Kansas authorises a fee but does not publish its amount anywhere we could read. The statute creates the charge and routes the money: 'The secretary for aging and disability services shall fix, charge and collect a fee to cover all or any part of the costs of the licensing agency under this subsection. The fee shall be fixed by rules and regulations of the secretary,' remitted to the state treasurer under K.S.A. 75-4215 and credited 'to the health occupations credentialing fee fund created by K.S.A. 39-979' (K.S.A. 39-936(c)(5)). That fund exists and is administered by the secretary (K.S.A. 39-979(a)). The amount lives in rules and regulations that could not be read as of August 16, 2026, and KDADS's published fee documents cover other credentials — its Licensure page lists prorated licensure fee schedules for operators, speech-language pathologists and audiologists, and dietitians, and none for nurse aides. KDADS does publish a universal 'Credit Card Authorization' form on its Applications & Forms page, which implies a payable charge, but no dollar figure appears there either. No dollar amount is stated on this page. Separately, training tuition is not set by the state: courses are run by adult care homes, hospitals, hospices, PACE programmes and other approved sponsors, and no Kansas source read publishes a price or a cap. Kansas also publishes no statement about who bears the cost of training — the pro rata reimbursement rules that some states publish were searched for in K.S.A. 39-936, 39-970 and 39-979 and on every readable KDADS Health Occupations Credentialing page, and none appears.",
   "legal_basis": "[{\"citation\": \"Kan. Stat. Ann. 39-936 (Statement on admission; qualified personnel; education and training of unlicensed employees and certified nurse aides; requirements for instructors thereof; examination and fees; state registry established; refresher course required...), as amended through L. 2024, ch. 103, § 3\", \"what_it_governs\": \"The whole Kansas nurse aide scheme: the 40 hours of basic resident care skills and the four-month progress rule, the requirement that those 40 hours be part of an approved certified nurse aide course, the course-supervisor and instructor licensure and good-standing conditions, the eight-hour paid nutrition assistant floor tied to 42 C.F.R. 483.160, the 90-day employment clock for completing an approved course and examination, the prohibition on requiring a particular course before the examination, the examination's design and uniformity, the fee and its deposit to the health occupations credentialing fee fund, the OBRA-87 state registry, the employer's duty to inquire of the registry, the refresher course after 24 consecutive months without direct care, and out-of-state recognition without examination on an equivalence finding.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0036.html\"}, {\"citation\": \"Kan. Stat. Ann. 39-923 (Definitions)\", \"what_it_governs\": \"The definition of 'adult care home' — nursing facility, nursing facility for mental health, intermediate care facility for people with intellectual disability, assisted living facility, residential healthcare facility, home plus, boarding care home and adult day care facility — which is what fixes the settings the nurse aide requirement reaches, and the definition of paid nutrition assistant that 39-936 cross-references.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0023.html\"}, {\"citation\": \"Kan. Stat. Ann. 39-970 (Adult care home; background check of employees; disqualification for employment; waiver and criteria; rules and regulations; submission of fingerprints, cost)\", \"what_it_governs\": \"The criminal-history regime that sits alongside certification: the definitions of applicant, direct access, direct supervision, completion of the sentence, employment agency and independent contractor; the prohibition on operating an adult care home in which a person with adverse registry findings or a listed conviction works; the exemptions for certain licensed or registered professional service providers, volunteers and employees; the waiver and its criteria; the Kansas Bureau of Investigation reporting duty; and fingerprint submission and cost.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0070.html\"}, {\"citation\": \"Kan. Stat. Ann. 39-979 (Fees; health occupations credentialing fee fund)\", \"what_it_governs\": \"The fund into which the nurse aide fee authorised by 39-936(c)(5) is deposited, administered by the secretary for aging and disability services.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0079.html\"}, {\"citation\": \"KDADS 'Certified Nurse Aide Regulations' — the agency's own compilation of the Kansas Administrative Regulations for this credential, published on its Regulations & Statutes page alongside Certified Medication Aide Regulations and Home Health Aide Regulations\", \"what_it_governs\": \"The rules the statute repeatedly delegates to: the definition of course supervisor, the approval standards for courses, the fee amount, the examination's administration, and the definition of adverse registry findings. Its text is not quoted anywhere on this page. The document would not open to any request as of August 16, 2026, from two different network locations, and Kansas's administrative regulations website would not deliver rule text either — so every point on this page that depends on a rule rather than a statute is left unstated, and the page says so, rather than being filled from another state or from memory.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/regulations-statutes\"}, {\"citation\": \"Pub. L. 100-203, subtitle C (OBRA-87), as amended November 5, 1990, and 42 CFR Part 483, Subpart D\", \"what_it_governs\": \"The federal frame Kansas names directly: K.S.A. 39-936(c)(6) requires the state registry 'in compliance with the requirements pursuant to PL 100-203, subtitle C, as amended November 5, 1990', which is the statute behind 42 CFR 483.150-.158 — state approval of nurse aide training and competency evaluation programs, the competency evaluation, and the registry itself. Kansas's paid-nutrition-assistant provision separately names 42 C.F.R. 483.160.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Kansas runs its own examination. No national testing company is named on any KDADS page we checked, and the statute puts the exam in the secretary's hands: 'The examination shall be: (A) Prescribed by the secretary for aging and disability services; (B) reasonably related to the duties performed by unlicensed employees working in adult care homes who provide direct, individual care to residents and who do not administer medications to residents; and (C) the same examination given by the secretary for aging and disability services to all unlicensed employees working in adult care homes who provide direct, individual care to residents and who do not administer medications' (K.S.A. 39-936(c)(4)). KDADS's own paperwork calls it the state exam — its forms list includes a 'Nurse Aide Accomodation Request Form (State Exam)' — and the agency publishes its own list of sites, 'Test Sites - Nurse Aide & Home Health Aide Exams', on both its training-provider page and its applications-and-forms page, together with a 'Rescheduling Exam Request' form. Certification and test questions route to a named HOC staff member: 'Certification of CNAs, CMAs, HHAs, Test Information — Elizabeth Hernandez 785-296-6877.'",
   "training_hours": "90 hours. KDADS publishes the figure in its own course materials rather than in a single headline sentence, and it appears twice: the agency's list of training courses by city and date is organised by discipline and names 'CNA - 90-Hour' alongside 'CMA - 75-Hour' and 'HHA - 20-Hour'; and its guidance to training sponsors states that its ban list 'will benefit sponsors applying for 90-Hour CNA courses when adding clinical sites.' The statute does not state 90 — and the reader is owed that. K.S.A. 39-936 fixes only the entry block: 40 hours of training in basic resident care skills, which 'shall be a part of an approved certified nurse aide training course', with the rule that an employee who has not completed those 40 hours, or who is 'not making progress to complete the course of education and training required by the secretary... within four months following completion of such 40 hours', may not provide direct, individual care. The total length, and any classroom/clinical/laboratory split, are set by the secretary's rules and regulations and by KDADS's published curriculum. No classroom/clinical split is stated on this page, because none was published in any Kansas source that could be read as of August 16, 2026: the KDADS document titled 'Certified Nurse Aide Regulations' and the Nurse Aide Course Curriculum could not be opened, and Kansas's administrative regulations site would not deliver rule text. What KDADS does publish about course design, and what this page can therefore state, is procedural: a Nurse Aide Course Curriculum and a CNA Instructor Manual exist and sponsors are expected to use them; a NATCEP Checklist governs approval; clinical sites are checked against a ban list; and online or distance delivery is throttled — 'The first two courses offered by an approved sponsor through a system of training using the internet or distance learning technologies will be under pilot status and will require a written proposal submitted at least four weeks before the start date of the course', with separate published guidelines for internet delivery and for distance-learning technologies, plus an attestation form, a CNA class schedule and content document and a student evaluation form for each mode.",
   "lapse_rule": "Kansas's published mechanism is the refresher course, not an expiry date. The trigger is 24 consecutive months without providing direct, individual care to residents since passing the examination, and the duty to enforce it sits with the employer: 'The adult care home shall require any certified nurse aide working in an adult care home to complete an approved refresher course if such employee: (i) Provides direct, individual care to residents; (ii) does not administer medications; and (iii) since passing the examination required under paragraph (2), has had a continuous period of 24 consecutive months when the certified nurse aide has not provided direct, individual care to residents' (K.S.A. 39-936(c)(8)(A)). KDADS approves the refresher courses and publishes the sponsor paperwork for them, including a CNA Refresher Update Certification Form — the document by which a completed refresher is recorded back onto the certification. The other way a Kansas certification stops being usable is an adverse finding, and Kansas frames that as an employment prohibition on the facility rather than as a revocation of the person's certificate: no one may knowingly operate an adult care home in which there works 'any person who has adverse findings on any state or national registry, as defined in rules and regulations adopted by the secretary for aging and disability services', or who has been convicted of, or adjudicated a juvenile offender for, the offences listed in K.S.A. 39-970(b)(1). KDADS publishes a separate public page for 'Findings of Abuse, Neglect or Exploitation'. The section provides for a waiver and criteria, but the criteria live in rules that could not be read as of August 16, 2026, so this page states no waiver test. Whether a certification itself expires after a period of non-use — as distinct from triggering the refresher requirement — is not stated in K.S.A. 39-936 or on any readable KDADS page.",
   "reciprocity": "Kansas recognises out-of-state nurse aides by statute, and the test is an equivalence judgement made by the Secretary: 'Any person who has been employed as a certified nurse aide working in an adult care home in another state may be so employed in this state without an examination if the secretary for aging and disability services determines that such other state requires training or examination, or both, for such employees at least equal to that required by this state' (K.S.A. 39-936(d)). Three things in that sentence are worth reading closely. It is framed as permission to be employed in Kansas rather than as an automatic transfer of a credential; the waiver it grants is of the examination specifically; and the standard is 'training or examination, or both... at least equal', which is a determination rather than a checklist — so an aide from a state with a shorter course than Kansas's 90 hours cannot assume the finding will go their way. KDADS's mechanism for it is a form on its Applications & Forms page called 'Interstate Application', filed alongside an 'Employment Verification' form. No fee, processing time, documentation list or published list of qualifying states accompanies it in any Kansas source we checked, and this page states none.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"KDADS — Health Occupations Credentialing (the programme's landing page). Establishes that KDADS runs the Kansas Nurse Aide Registry and that 'Kansas Nurse Aide Registry - This website is considered primary source verification. The registry information on the website is real-time with the registry database'; the parallel License Verification statement; the Findings of Abuse, Neglect or Exploitation page; the professional mailing lists route; the HOC office address at 503 S Kansas Ave., Topeka; and the named staff routing — the CNA, HHA, CMA Program, 'Certification of CNAs, CMAs, HHAs, Test Information' and 'Nurse Aide Registry General Questions' at 785-296-6877, and the Education Program covering instructor approvals and certification course approvals.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing\"}, {\"label\": \"KDADS — All Training Courses / Continuing Education. Establishes the course catalogue by discipline in KDADS's own words — 'CNA - 90-Hour; CNA Refresher; CMA Update; CMA - 75-Hour; HHA - 20-Hour; Activities Director / Social Services Designee; Nutrition Assistant; Operator' — and the continuing-education material published for adult care home administrators, dietitians, operators and speech-language pathologists and audiologists, with none for nurse aides.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/all-training-courses-continuing-education\"}, {\"label\": \"KDADS — Training Provider Information, Resources & Forms. Establishes the sponsor-side machinery: the CNA Instructor Application (Course Supervisor Use Only), Course Supervisor Application, Course Approval Application and Course Roster Submission Form; the 'Facilities with Active Ban' list and its purpose for 'sponsors applying for 90-Hour CNA courses when adding clinical sites', including that 'Any waiver presented for a facility with a ban that is not yet back in compliance will be denied, and the sponsor will be notified that a new clinical site is required'; the online/distance-learning pilot rule ('The first two courses offered by an approved sponsor through a system of training using the internet or distance learning technologies will be under pilot status and will require a written proposal submitted at least four weeks before the start date of the course'); and the nurse aide document set — Nurse Aide Accomodation Request Form (State Exam), CNA Class Roster, CNA Instructor Manual, CNA Refresher Course FAQs, CNA Refresher Course Instructions - Guidelines, CNA Refresher Course Roster, CNA Refresher Update Certification Form, NATCEP Checklist, Nurse Aide Course Curriculum, OTAPTA Nurse Aide Bridge Course Outline, Test Sites for Nurse Aide and Home Health Aide Exams, Waiver Application and Waiver Evaluation Form.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/training-provider-information-resources-forms\"}, {\"label\": \"KDADS — Applications & Forms. Establishes the candidate-side form set for certification: Nurse Aide Accommodation Request Form, Allied Health Form, 'Documentation of Training for Challenging Test', Employment Verification, Interstate Application, Rescheduling Exam Request, Test Sites for Nurse Aide and Home Health Aide Exams, plus the universal Credit Card Authorization and Name or Address Change Certification forms.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/applications-forms\"}, {\"label\": \"KDADS — Regulations & Statutes (Health Occupations Credentialing). Establishes that KDADS publishes a document set titled 'Certification Regulations' containing 'Certified Medication Aide Regulations', 'Home Health Aide Regulations' and 'Certified Nurse Aide Regulations', separately from the 'Statutes & Regulations' sets for adult care home administrators, dietitians, operators and speech-language pathologists and audiologists. The Certified Nurse Aide Regulations document itself could not be opened.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/regulations-statutes\"}, {\"label\": \"KDADS — Licensure. Establishes the Online License Renewal opening dates for the credentials KDADS renews — 'Dietitian: January 15; Operators: March 15; Adult Care Home Administrators: May 15; Speech-Language Pathologists: September 15; Audiologists: September 15' — with nurse aides absent from the list, and the prorated licensure fee schedules published for operators, speech-language pathologists and audiologists, and dietitians.\", \"url\": \"https://www.kdads.ks.gov/licensing-policy/health-occupations-credentialing/licensure\"}, {\"label\": \"Kan. Stat. Ann. 39-936, Kansas Office of Revisor of Statutes. Establishes every statutory quotation on this page: the 40 hours of basic resident care skills and the four-month progress rule; 'The 40 hours of training required in this section shall be a part of an approved certified nurse aide training course'; the instructor licensure and 'in good standing' definition; the paid nutrition assistant's eight hours under 42 C.F.R. 483.160; the 90-day employment clock; 'The licensing agency shall not require unlicensed employees... to enroll in any particular approved course of instruction as a condition to the taking of an examination'; the examination's three design conditions; the fee and the health occupations credentialing fee fund; the state registry 'pursuant to PL 100-203, subtitle C, as amended November 5, 1990'; the employer's duty to inquire of the registry; the 24-month refresher trigger; and the out-of-state provision at subsection (d). Amendment history through L. 2024, ch. 103, § 3.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0036.html\"}, {\"label\": \"Kan. Stat. Ann. 39-923, Kansas Office of Revisor of Statutes. Establishes the definition of 'adult care home' and of each facility classification inside it, which fixes the settings the nurse aide requirement reaches.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0023.html\"}, {\"label\": \"Kan. Stat. Ann. 39-970, Kansas Office of Revisor of Statutes. Establishes the adult care home background-check regime, its defined terms including 'direct access', and the prohibition on operating a home in which a person with adverse state or national registry findings or a listed conviction works.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0070.html\"}, {\"label\": \"Kan. Stat. Ann. 39-979, Kansas Office of Revisor of Statutes. Establishes the health occupations credentialing fee fund into which the nurse aide fee is deposited.\", \"url\": \"https://www.ksrevisor.gov/statutes/chapters/ch39/039_009_0079.html\"}, {\"label\": \"Kansas Nurse Aide Registry public lookup, the site KDADS links from its Health Occupations Credentialing page and describes as primary source verification with real-time registry data.\", \"url\": \"https://ksdadsv7prod.glsuite.us/glsuiteweb/clients/ksdads/public/CertificationVerification.aspx\"}]",
   "page_url": "https://licensingatlas.com/cna/ks-cna/"
  },
  {
   "page_id": "ky-cna",
   "state": "Kentucky",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Kentucky Board of Nursing (KBN) — which maintains the Kentucky Nurse Aide Registry and issues the State Registered Nurse Aide (SRNA) certification — under an interagency agreement with the Cabinet for Health and Family Services, Department for Medicaid Services (Kentucky Medicaid), which owns the programme rules. Kentucky splits the work three ways and says so itself: 'The Kentucky Community and Technical College System (KCTCS) administers the Kentucky Nurse Aide Training Program. Kentucky Medicaid provides oversight, technical assistance, and nurse aide training reimbursement,' while KBN holds the registry — 'Kentucky Medicaid, through an interagency agreement with the Kentucky Board of Nursing, is responsible for establishing and maintaining a registry of all nurse aides.' Abuse investigations belong to a fourth office: the Cabinet's Office of Inspector General.",
   "board_url": "https://kbn.ky.gov/state-registered-nurse-aide/Pages/default.aspx",
   "application_url": "https://kybn.boardsofnursing.org/kybn",
   "renewal_cycle": "Every two years, and the clock starts at the exam. 'The state registered nurse aide active status is valid for two years and must be renewed. The date you passed your nurse aide competency examination is the date used for renewal of your SRNA status.' Kentucky Medicaid states the same rule from the registry side and adds the consequence: 'The nurse aide registry will renew a nurse aide's registration at least once every 24 months. Registration will be denied if the nurse aide has not worked eight hours for compensation for 24 consecutive months or longer.' What renewal actually requires is proof of work: 'Proof of a minimum of eight hours of employment as a state registered nurse aide performing nursing or nursing-related functions for compensation in each 24-month period is required. Proof of employment can be one of the following: Paycheck Stub; W-2 form from the previous year; Letter from a healthcare facility on official letterhead signed and dated by the appropriate party.' How you file it: through the Board's Nurse Portal — ''Apply for renewal' will appear next to your SRNA Certification on the Nurse Portal Dashboard' and 'The renewal will appear no sooner than 60 days prior to your expiration date.' You will not be reminded. Since the Board moved to its current license-management system on March 20, 2023, 'The Kentucky Nurse Aide Registry will no longer be mailing renewal reminders or certification letters' — so the aide is responsible for watching the expiry date, which the Board says to check through its own verification portal. A separate route exists for private-duty aides, because a private employer cannot issue a pay stub on facility letterhead: an SRNA doing private duty nursing 'must have the person they are caring for or a family member of that individual complete a State Registered Nurse Aide (SRNA) Private Duty Form', the employer 'must sign and date the form in front of a notary public', and the form must list the nursing-related duties performed, the dates of employment, proof of payment for services, and the individual's or family member's full name, address and telephone number.",
   "ce_hours": "No continuing education is required of the aide to renew. Kentucky's renewal test is eight hours of paid nursing or nursing-related work in each 24-month period, not coursework — the Board's renewal page lists only that proof, and no course, hour count or approved-provider list appears anywhere on the Board's SRNA pages, in 907 KAR 1:450, or in 906 KAR 1:100 (all checked). The twelve-hour figure people quote is a facility duty: 'A nursing facility shall provide and document that at least twelve (12) hours of ongoing staff development training is given annually to each nurse aide who: (1) Is employed by the facility; and (2) Has satisfactorily completed the nurse aide training and competency evaluation program' (907 KAR 1:450, Section 4). Kentucky Medicaid files that same rule on its own page under the heading 'How Do I Stay Active?', which is the likeliest source of the confusion — but the obligation to provide and document it runs to the nursing facility, and the note the department attaches immediately afterwards is the one that governs registry status: registration 'will be denied if the nurse aide has not worked eight hours for compensation for 24 consecutive months or longer.'",
   "exam": "Two parts, and you choose the format of one of them. 'The competency examination consists of both a written or oral examination and a skills performance examination' (KCTCS), and the regulation guarantees the choice: 'An individual who obtains nurse aide training from an entity identified in Section 5(1)... shall be permitted to choose between a final written or oral competency examination' (907 KAR 1:450, Section 7(2)(a)). Both must be passed: 'An individual shall pass the written or oral competency examination and the skills demonstration for satisfactory completion of the nurse aide training and competency evaluation program' (Section 7(7)(a)). How the test is built, which few states put in regulation: the examination shall 'Be developed from a pool of test questions, only a portion of which shall be used in any one (1) competency examination', shall 'Use a system that prevents disclosure of both the pool of questions and the individual competency examinations', and 'If oral, be read from a prepared text in a neutral manner.' The skills portion: it 'shall be: (a) Performed in a facility or laboratory setting comparable to the setting in which the individual shall function as a nurse aide; and (b) Administered by a registered nurse with at least one (1) year's experience in providing care for the elderly or chronically ill of any age' (Section 7(3)). Attempts: the regulation requires the administering agency to tell a candidate who fails 'Of the areas which the individual did not pass' and 'That the individual has at two (2) additional opportunities to take the examination' (Section 7(8)) — three attempts in total; the sentence as published contains a stray word, and it is quoted here as written rather than tidied. Results are stated two ways. KCTCS's current manual: 'Each candidate will receive notification of test scores via email. The candidate can log into their account on ky.tmutest.com to view their results within 72 hours', and a candidate who passes both parts has their name made available to the Kentucky Nurse Aide Registry 'within 30 days'. The Board of Nursing's SRNA page: 'Test results are usually available within 30 days of taking the examination. If less than 30 days have passed since your test date, do not contact KCTCS. If more than 30 days have passed, please call 1-877-528-2748. Test scores will NOT be given out over the phone.' A grade appeal exists: 'A formal process has been established for test takers to appeal their grades on the competency evaluation. Grade appeals should be based on testing irregularities or process violations.' The regulation does not state the number of questions, the time allowed, the passing score or the number of skills; KCTCS's Kentucky Medicaid Nurse Aide Training Manual (revision 7/14/26) does. To pass, the candidate must 'Make a score of at least 70% on the timed (2hr limit) 75 multiple-choice written examination' and 'successfully demonstrate at least five (5) procedures under the observation of an examiner with 70% accuracy', with the critical steps, shown in bold, performed 'with 100% accuracy'. Three of the five skills are set in a scenario and two are done on their own.",
   "fees": "The state charges for the examination, and KCTCS publishes the schedule. 'Testing Fees as of 7/1/24 — Testing Fees are Non-Refundable. SRNA EXAM: Written $40 (Oral/Audio $55); Skills $95. Secondary students will be charged at the standard pricing structure. Medication Aide Exams: KMA/CMA I $50; CMA II $50.' So an ordinary candidate taking the written form pays $40 + $95 = $135, and choosing the oral or audio form raises the first figure to $55. No registry fee is published. The Board of Nursing's fee regulation, 201 KAR 20:240 ('Fees for applications and services'), was read in full and contains no nurse aide or SRNA fee at all — its authority and its schedule run to licenses under KRS Chapter 314, which is the nursing statute. Neither the Board's SRNA pages (overview, how to become, renewal, reinstatement, reciprocity, verification) nor 907 KAR 1:450 nor 906 KAR 1:100 states a fee for registry listing, renewal, reinstatement or reciprocity. No tuition figure is set by the state: the course is run by an approved provider, and Kentucky publishes no price. KCTCS points students at aid rather than at a price — 'Need help paying for your nurse aide education? Scholarships may be available sponsored by the Kentucky Lottery! Grab your potential winning ticket and seek out a KCTCS financial aid specialist.' What Kentucky reimburses is the facility, not the aide, capped at 'forty-five (45) cents per Medicaid patient day' — see requirements.",
   "legal_basis": "[{\"citation\": \"907 Ky. Admin. Regs. 1:450 (Nurse aide training criteria and registry), Technical Amendment effective 11-28-2022; history: eff. 9-20-1989; 2-17-1993; 4-16-1997; 12-1-2006; Crt eff. 12-6-2019\", \"what_it_governs\": \"The operative Kentucky nurse aide regulation: the definitions of nurse aide, licensed health professional, competency examination and supervised practical training; the four-month rule and the conditions inside it; the 75 clock hours and 16 hours of supervised practical training and the instructor qualifications; the 12 hours of annual facility-provided staff development; who may seek approval to run a programme and the approval, on-site review and withdrawal regime; the competency examination — KCTCS or another approved non-facility entity, the written-or-oral choice, the question-pool and security rules, the skills demonstration and its evaluator, the identity documents a candidate must present, the three attempts, and the 30-day registry entry; the registry itself and the interagency agreement with the Kentucky Board of Nursing; reciprocity and its absolute abuse-registry bar; the 45-cents-per-Medicaid-patient-day reimbursement to nursing facilities; and the incorporation by reference of the Medicaid Services Manual for the programme.\", \"url\": \"https://apps.legislature.ky.gov/law/kar/titles/907/001/450/\"}, {\"citation\": \"906 Ky. Admin. Regs. 1:100 (Nurse aide abuse registry, home health aide abuse registry, and hearing procedures), certified effective 12-1-2025\", \"what_it_governs\": \"The other half of the Kentucky registry: the definitions of abuse, neglect, misappropriation and 'certified'; the cabinet's preliminary determination and the ten-working-day notice to the aide and the facility; the thirty-day window to request a hearing and the KRS Chapter 13B hearing procedure, exceptions and final order; what the abuse registry entry must contain, including the aide's own summary statement disputing the findings, which 'shall be disclosed in response to inquiries made to the registry'; who must be told; and the Section 5 petition to have a neglect finding removed after one year on proof of no pattern and a singular occurrence.\", \"url\": \"https://apps.legislature.ky.gov/law/kar/titles/906/001/100/\"}, {\"citation\": \"Ky. Rev. Stat. 216.935 (Definitions for KRS 216.935 to 216.939), effective June 29, 2021\", \"what_it_governs\": \"The statutory definition of 'nurse aide' — 'an individual, including a nursing student, medication aide, and a person employed through a nursing pool, who provides nursing or nursing related services to a resident in a nursing facility or home health agency' — with the same three exclusions the regulation uses, plus the definitions of home health aide, home health agency, home health aide services and direct-care staff member.\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=51061\"}, {\"citation\": \"Ky. Rev. Stat. 216.936 (Expansion of nurse aide abuse registry to include home health aides), effective June 20, 2005\", \"what_it_governs\": \"The statutory command behind the abuse registry: 'The Cabinet for Health and Family Services shall establish an abuse registry to include information pertaining to findings of resident neglect as defined at 42 C.F.R. 488.301 or abuse as defined at 42 C.F.R. 488.301, and misappropriation of resident property by a nurse aide or home health aide. The abuse registry may be created by expanding or modifying the existing nurse aide abuse registry to include home health aides as permitted by 42 C.F.R. 483.156.'\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=9152\"}, {\"citation\": \"902 Ky. Admin. Regs. 20:300 (nursing facility licensure), as applied by the Kentucky Board of Nursing\", \"what_it_governs\": \"The employment bar the Board cites to facilities: it 'requires that a nursing facility shall not be operated by or employ any person who is listed on the: Nurse aide abuse registry or Caregiver misconduct registry.' The regulation's own text was not read for this page; this page states only what the Board says the regulation requires, and attributes it to the Board.\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/srna-verification.aspx\"}, {\"citation\": \"42 CFR Part 483, Subpart D — 42 CFR 483.150, 483.151, 483.152, 483.154 and 483.156\", \"what_it_governs\": \"The federal frame Kentucky adopts by direct reference rather than restating: the grandfathering and exception routes at 483.150(a), (b) and (c) that Kentucky's four-month rule and registry both point to; the programme approval and withdrawal standards at 483.151 and 483.152; the competency evaluation requirements at 483.154 that Kentucky's examination rules track subsection by subsection; and the registry duty at 483.156.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "KCTCS — the Kentucky Community and Technical College System — is the sole administrator, with the test itself delivered on the TMU/Headmaster platform. The regulation names the arrangement in the abstract: 'KCTCS or another department-approved entity that is not a nursing facility shall administer and evaluate the final examination, including the skills demonstration portion of the nurse aide training and competency evaluation' (907 KAR 1:450, Section 7(1)) — note the exclusion of nursing facilities from evaluating their own trainees. KCTCS states it flatly: 'KCTCS is the sole administrator for the nurse aide competency evaluation', and the Board agrees: 'Kentucky Community and Technical College System (KCTCS) is the sole provider of nurse aide testing.' Kentucky Medicaid confirms the same division: 'The Kentucky Community and Technical College System (KCTCS) administers the Kentucky Nurse Aide Training Program.' Since a platform change KCTCS describes as a 'New Site by TMU/Headmaster', registration and results run through ky.tmutest.com, where 'Students can schedule themselves once the course is completed' and 'Students will be notified by email when results are ready and have their own login to view results.'",
   "training_hours": "75 clock hours minimum, of which at least 16 must be supervised practical training. The regulation states both in one place: a nurse aide training and competency evaluation program shall '(1) Consist of a minimum of seventy-five (75) clock hours of nurse aide instructional training; (2) Include at least sixteen (16) hours of supervised practical training' (907 KAR 1:450, Section 3). 'Supervised practical training' is itself defined, and the definition is what makes the 16 hours meaningful: 'training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse' (Section 1(7)). Kentucky publishes no further split — no separate classroom figure, no clinical-facility minimum, no cap on laboratory hours appears in the regulation or on any Kentucky page we checked, so none is stated here. Instructor qualifications are in the same section and are stricter than the hours: the programme's instructor must '(a) Demonstrate completion of a course in teaching adults or have experience teaching adults; and (b) Be a registered nurse who possesses a minimum of two (2) years of nursing experience, at least one (1) year of which shall be in the provision of long-term care services; or (c) Be a licensed practical nurse who: 1. Has at least one (1) year of experience; and 2. Provides instruction as a supplement to the registered nurse instructor.' What the course content comes from: the regulation adopts the federal standards at 42 C.F.R. 483.152 and incorporates by reference the 'Medicaid Services Manual for Nurse Aide Training and Competency Evaluation Program, March 2005 edition', which may be 'inspected, copied, or obtained... at the Department for Medicaid Services, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.' That manual is a paper document held at a state office rather than a published web page — KCTCS links it to students as the source 'all nurse aide training programs are required to follow', but its contents are not quoted anywhere on this page.",
   "lapse_rule": "Status ends after 24 consecutive months without paid nursing work — and Kentucky gives a retroactive fix as well as a retest. The rule: registration 'will be denied if the nurse aide has not worked eight hours for compensation for 24 consecutive months or longer' (Kentucky Medicaid). The first way back is evidence, not an exam: 'You may reinstate your registry status if you can provide evidence that you were employed in a nursing-related capacity for at least eight paid hours prior to the expiration date,' and — the detail most reinstatements fail on — 'You must provide proof of working eight paid hours for every two years the registration has been lapsed.' So a five-year gap needs proof for each two-year window, not one shift. Accepted proof is the same short list as renewal: a paycheck stub, a W-2 from the previous year, or a letter from a healthcare facility on official letterhead, signed and dated; private-duty work uses the notarised SRNA Private Duty Form. The second way back is to start over: 'If you cannot show such proof of employment, contact KCTCS to retake the nurse aide classes and competency test.' Reinstatement is filed through the Board's Nurse Portal — ''Apply for reinstatement' will appear next to your SRNA Certification on the Nurse Portal Dashboard.' An abuse finding is a separate and heavier status, with its own procedure and its own narrow exit — see the abuse-registry material under exemptions and in the legal basis. The removal route reaches neglect findings only: an aide added to the abuse registry after January 1, 1995 'may petition the cabinet to review the finding of nurse aide or home health aide neglect after the passage of one (1) year' from listing, and the secretary shall remove the name if the aide proves that 'The employment and personal history of the nurse aide or home health aide does not reflect a pattern of abusive behavior, neglect or misappropriation of property' and that 'The neglect involved in the finding... was a singular occurrence' (906 KAR 1:100, Section 5). A refusal can be taken to a hearing within 30 days.",
   "reciprocity": "Kentucky grants reciprocity on three conditions and refuses it absolutely on one. The regulation: 'The department shall grant reciprocity for a nurse aide who is on another state's nurse aide registry if: (a) The other state provides documentation that the individual is on its registry; (b) An employment record provided to the department's nurse aide registry verifies that twenty-four (24) months have not elapsed since the individual worked for pay as a nurse aide; and (c) The individual is not listed on the other state's registry of resident abuse, neglect, or misappropriation of resident property.' And then, flatly: 'The department shall not grant reciprocity for an individual whose name appears on any state's abuse registry' (907 KAR 1:450, Section 9) — note 'any state's', not just the sending state's. What the verification must contain, per Kentucky Medicaid: the individual 'may be deemed competent for employment in a nursing facility based on written verification from the agency that maintains the state's nurse aide registry. This verification will include the: aide's name; Social Security number or other identification; the date the name was placed on the registry; and any documented findings pertaining to the individual. In addition, an employment record shall be provided to the registry to verify that 24 months have not expired since the registrant worked for pay as an aide. Reciprocity shall not be granted for anyone who has a validated complaint documented on a registry.' How you file it: through the Board's Nurse Portal, selecting the 'State Registered Nurse Aide (SRNA) Reciprocity Application'. The Board lists what the application asks for — full name, telephone number, mailing address, Social Security number, date of birth, name of the state currently certified in, and certification or registration number — and what must be uploaded: 'Social Security Card; Driver's License and State Certification', with the note that 'You may be requested to upload a copy of current paystub.' If you are not active anywhere, there is no transfer: 'You must take an approved training course and the competency evaluation in Kentucky.' Going the other way is the receiving state's process: 'To transfer from the Kentucky Nurse Aide Registry to another state, the nurse aide will need to contact the state to which you are transferring.' No fee for reciprocity is published in the regulation or on any Board page we checked.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Kentucky Board of Nursing — State Registered Nurse Aide (overview). Establishes 'The Kentucky Nurse Aide Registry began in October 1990 after the Omnibus Budget Reconciliation Act (OBRA) became law' and the registry's 'two main functions'; 'All long-term care facilities must check the registry and abuse status of individuals before hiring them'; the March 20, 2023 move to the Board's cloud-based license system and that 'The Kentucky Nurse Aide Registry will no longer be mailing renewal reminders or certification letters'; that reciprocity, reinstatement and renewal are all filed through the Board's Nurse Portal; the name- and address-change procedures; that the Cabinet's Office of Inspector General 'investigates all allegations of abuse, neglect or misappropriation of property that are made regarding a SRNA'; and the referrals to KCTCS for testing and to the Department for Medicaid Services for training-programme rules and grandfathering.\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/default.aspx\"}, {\"label\": \"Kentucky Board of Nursing — How do I Become a State Registered Nurse Aide (SRNA). Establishes 'The Kentucky Board of Nursing maintains the Kentucky Nurse Aide Registry', 'Kentucky Community and Technical College System (KCTCS) is the sole provider of nurse aide testing', 'KCTCS provides the Kentucky Board of Nursing with a copy of the test scores and information about individuals who complete the course and pass the competency exam', and the 30-day results expectation with the 1-877-528-2748 number and 'Test scores will NOT be given out over the phone.'\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/how-to-become-an-srna.aspx\"}, {\"label\": \"Kentucky Board of Nursing — SRNA Renewal. Establishes 'The state registered nurse aide active status is valid for two years and must be renewed. The date you passed your nurse aide competency examination is the date used for renewal of your SRNA status'; that renewal appears on the Nurse Portal dashboard 'no sooner than 60 days prior to your expiration date'; the eight-hours-per-24-months proof requirement and the three accepted proofs; and the notarised State Registered Nurse Aide (SRNA) Private Duty Form and its four required contents for aides doing private duty nursing.\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/srna-renewal.aspx\"}, {\"label\": \"Kentucky Board of Nursing — SRNA Reinstatement. Establishes 'You may reinstate your registry status if you can provide evidence that you were employed in a nursing-related capacity for at least eight paid hours prior to the expiration date'; 'You must provide proof of working eight paid hours for every two years the registration has been lapsed'; and 'If you cannot provide proof of employment, you must retake the SRNA classes and test.'\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/srna-reinstatement.aspx\"}, {\"label\": \"Kentucky Board of Nursing — SRNA Reciprocity. Establishes that 'Reciprocity allows a state registered nurse aide to transfer their registration from one state to another state'; the Nurse Portal filing route and the 'State Registered Nurse Aide (SRNA) Reciprocity Application'; the information the application asks for and the documents to upload (Social Security card, driver's license and state certification, and possibly a current paystub); that an applicant without active status elsewhere 'must take an approved training course and the competency evaluation in Kentucky'; and that an outbound transfer starts with the receiving state.\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/srna-reciprocity.aspx\"}, {\"label\": \"Kentucky Board of Nursing — SRNA Verification. Establishes that as of March 20, 2023 all KBN credentials are verified through the Board of Nursing License Verification Portal; that facilities can search by Name, License Number or NCSBN ID; that '902 KAR 20:300 requires that a nursing facility shall not be operated by or employ any person who is listed on the: Nurse aide abuse registry or Caregiver misconduct registry'; the exact abuse-registry message a lookup returns; 'The Kentucky Board of Nursing only has a record of individuals who have or have held a SRNA#'; the OIG-approved 'Primary Source Board of Nursing Report Summary form'; the separate Kentucky adult caregiver misconduct registry check by Social Security number; and 'All verifications must be completed online.'\", \"url\": \"https://kbn.ky.gov/state-registered-nurse-aide/Pages/srna-verification.aspx\"}, {\"label\": \"Cabinet for Health and Family Services, Department for Medicaid Services — Nurse Aide Training. Establishes the three-way split ('The Kentucky Community and Technical College System (KCTCS) administers the Kentucky Nurse Aide Training Program. Kentucky Medicaid provides oversight, technical assistance, and nurse aide training reimbursement. The Nurse Aide Training Program regulation is 907 KAR 1:450'); the definition and exclusions restated in plain terms; 'Kentucky Medicaid, through an interagency agreement with the Kentucky Board of Nursing, is responsible for establishing and maintaining a registry of all nurse aides'; the reimbursement prerequisites (nurse aide training vendor number, MAP-576 and affidavit); the 12-hour annual staff development duty; the note that 'The nurse aide registry will renew a nurse aide's registration at least once every 24 months. Registration will be denied if the nurse aide has not worked eight hours for compensation for 24 consecutive months or longer'; and the reciprocity verification contents with 'Reciprocity shall not be granted for anyone who has a validated complaint documented on a registry' and the Kentucky Nurse Aide Registry number (800) 305-2042.\", \"url\": \"https://www.chfs.ky.gov/agencies/dms/dca/Pages/natrain.aspx\"}, {\"label\": \"907 Ky. Admin. Regs. 1:450, Kentucky Legislative Research Commission. Establishes every regulatory quotation on this page: the definitions, the four-month rule, the 75 clock hours and 16 hours of supervised practical training, the instructor qualifications, the 12-hour staff development duty, the approval and withdrawal regime including the 'in, but not by' exception, the competency examination and its written-or-oral choice, question-pool security, skills-demonstration setting and evaluator, the candidate identity documents, the three attempts, the 30-day registry entry, the registry and its interagency agreement with the Kentucky Board of Nursing, the three reciprocity conditions and the absolute abuse-registry bar, the 45-cents-per-Medicaid-patient-day reimbursement cap, and the incorporation by reference of the March 2005 Medicaid Services Manual held at 275 East Main Street, Frankfort.\", \"url\": \"https://apps.legislature.ky.gov/law/kar/titles/907/001/450/\"}, {\"label\": \"906 Ky. Admin. Regs. 1:100, Kentucky Legislative Research Commission. Establishes the abuse-registry definitions and procedure — the preliminary determination and ten-working-day notice, the thirty-day hearing request, the KRS Chapter 13B hearing, exceptions and final order, the registry's required contents including the aide's disputing statement, and the Section 5 petition to remove a neglect finding after one year on proof of no pattern of abusive behaviour and a singular occurrence.\", \"url\": \"https://apps.legislature.ky.gov/law/kar/titles/906/001/100/\"}, {\"label\": \"KCTCS Nurse Aide — About. Establishes 'KCTCS is the sole administrator for the nurse aide competency evaluation. The competency examination consists of both a written or oral examination and a skills performance examination.'\", \"url\": \"https://nurseaide.kctcs.edu/about/index.aspx\"}, {\"label\": \"KCTCS Nurse Aide — Online Testing. Establishes the testing platform ('New Site by TMU/Headmaster', 'Website for Testing https://ky.tmutest.com'), the fee schedule 'as of 7/1/24' and that fees are non-refundable ('SRNA EXAM: Written $40 (Oral/Audio $55); Skills $95'; 'Medication Aide Exams: KMA/CMA I $50; CMA II $50'), that 'Students can schedule themselves once the course is completed' and are notified of results by email, the SRNA Challenge application route for nursing students, and the instruction that nurse aides from other states 'need to contact the KY State Board of Nursing for reciprocity instructions.'\", \"url\": \"https://nurseaide.kctcs.edu/online-testing/index.aspx\"}, {\"label\": \"KCTCS Nurse Aide — Resources for Nurse Aide Students. Establishes that the local 'KNAT Coordinator is your go-to resource', the Kentucky Lottery scholarship pointer, the statement that 'all nurse aide training programs are required to follow the regulations and guidelines contained in' the Medicaid Services Manual, the 'Prohibition Against Employing Certain Felons' notice, the grade-appeal process for the competency evaluation, and the warning that 'The Patient Care Technician pathway with KDE/OCTEST [sic] will not qualify students to take the Medicaid Nurse Aide Competency Exam to be a State Registered Nurse Aide.'\", \"url\": \"https://nurseaide.kctcs.edu/nurse-aide-resources/student-resources.aspx\"}, {\"label\": \"Ky. Rev. Stat. 216.935, Kentucky Legislative Research Commission. Establishes the statutory 'nurse aide' definition and its three exclusions, reaching a nurse aide 'in a nursing facility or home health agency', effective June 29, 2021.\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=51061\"}, {\"label\": \"Ky. Rev. Stat. 216.936, Kentucky Legislative Research Commission. Establishes the Cabinet's duty to run an abuse registry covering neglect and abuse as defined at 42 C.F.R. 488.301 and misappropriation of resident property by a nurse aide or home health aide.\", \"url\": \"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=9152\"}, {\"label\": \"Kentucky Board of Nursing License Verification Portal — the live lookup behind the license search on this page, whose own form fields establish the three search routes and the 'SRNA Certification' license type.\", \"url\": \"https://kybn.boardsofnursing.org/licenselookup\"}]",
   "page_url": "https://licensingatlas.com/cna/ky-cna/"
  },
  {
   "page_id": "la-cna",
   "state": "Louisiana",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Louisiana Department of Health (LDH), Health Standards Section - Louisiana Certified Nurse Aide Registry (LCNAR). The Department states the arrangement in its own words: 'The Louisiana Department of Health (LDH) - Health Standards Section (HSS) manages the Louisiana Nurse Aide Registry and the Direct Service Worker Registry,' and the regulation makes the Department the owner of the register: 'The Department of Health (LDH) shall develop and maintain the Louisiana Certified Nurse Aide Registry (LCNAR)' (LAC 48:I.10033.A). Testing is delivered by two Department-approved entities rather than by the Department itself: 'LDH utilizes Prometric and Louisiana Community & Technical College System (LCTCS) college sites to administer the LA Nurse Aide Competency Evaluation.' No Board of Nursing is involved - the Louisiana State Board of Nursing licenses nurses, and nothing in the nurse aide chapter routes any part of this credential through it.",
   "board_url": "https://ldh.la.gov/health-standards-section/cna-registry",
   "application_url": "https://ldh.la.gov/page/3013",
   "renewal_cycle": "Two years, renewed by working rather than by filing anything. The Department states the term and the condition together: 'Nurse aides are certified for 2 years, beginning with the certification date. Nurse aides are required to work at least 8 hours during every 24 month period (2 years) once certified. The 8 hours must include \"nursing or nurse related\" duties and must be performed in approved licensed settings.' The regulation puts the same duty on the aide: 'A nurse aide shall perform at least eight hours of nursing or nursing-related services in an approved setting during every consecutive 24-month period for pay after completion of a training and competency evaluation program to maintain certification' (LAC 48:I.10025.B) - note 'for pay'. The Department-linked bulletin adds a supervision element: 'You must have been performing nursing or nursing-related services for pay under the supervision of a licensed registered nurse.' What counts as an approved setting is defined by regulation as 'a provider entity licensed and regulated by the department, a school serving children with special needs, or a correctional facility in which the certified nurse aide performs nursing or nursing-related duties' (LAC 48:I.10001), and the Department lists examples: 'nursing homes, hospitals, home health agencies, personal care attendant agencies, assisted living programs, hospice agencies, respite agencies, supervised independent living agencies, adult day health care programs and intermediate care facilities for the developmentally disabled (ICF/DD) programs.' Two settings are called out as not qualifying: 'Private sitting or staffing agency work do not qualify as approved settings' - with the single exception the Department states elsewhere, that staffing-agency employment counts when the work was performed in a nursing home and the nursing home reports it. The reporting trap that ends most Louisiana certifications: an aide cannot report their own hours. 'CNAs cannot report their own work history. Work history MUST be submitted and will only be accepted from approved entities, including providers licensed by the Louisiana Department of Health, schools serving children with special needs, or correctional facilities where the CNA performs nursing-related duties.' Only nursing homes are obliged to report: 'hours worked in settings other than Nursing Homes are not required to be reported by provider but recommend to be submitted to ensure certification renewal.' Employers must notify the registry of employment or termination 'within five working days' (LAC 48:I.10045.C), and facilities must report staffing-agency aides 'at least monthly' (LAC 48:I.10045.F). An aide flagged for abuse, neglect or misappropriation is not renewable at all: 'Nurse aides that are flagged on the Registry for resident abuse, neglect, or misappropriation of property are not eligible for renewal' (Department-linked bulletin). The aide also carries a standing duty 'for notifying the registry of current contact information such as address, telephone number, and e-mail address' (LAC 48:I.10025.A).",
   "ce_hours": "No continuing education is required of the individual to renew. Louisiana renews a certification on paid work, not on course hours - LAC 48:I.10025 conditions maintenance solely on eight hours of paid nursing or nursing-related service per 24 months, and neither the Department's registry pages nor its certification-maintenance page names any course requirement for renewal. Sources checked: LAC 48:I, Chapter 100 in full, the Department's CNA Registry page, its Nurse Aide Training and Certification Maintenance page, its approved-testing-vendor page, and the Department-linked candidate bulletin. What does exist is an employer duty, and it is paid time: 'All facilities shall continue to provide on-going training on a routine basis in groups and, as necessary in specific situations, on a one-to-one basis. 1. Each nurse aide shall receive and be compensated for 12 hours of on-going training per year' (LAC 48:I.10045.D). That training 'may be conducted in the unit as long as it is: a. directed toward skills improvement; b. provided by appropriately trained staff; and c. documented.' Missing it is the facility's compliance failure, not a bar to the aide's renewal. One further recurring hour is written into the curriculum competencies rather than into renewal: attaining and maintaining proficiency in basic cardio-pulmonary resuscitation 'including one hour of in-service training that shall be provided by the facility annually' (LAC 48:I.10015.C.1.j).",
   "exam": "Two parts, both of which must be passed: a Knowledge (written) test, which may instead be taken orally, and a performance-based Clinical Skills test. Knowledge test - the Department-linked Prometric bulletin: 'The Knowledge Test consists of 60 multiple-choice questions that evaluate your nurse aide knowledge and skills. You will have 90 minutes to take the test.' Published content weighting includes Role of the Nurse Aide at 20 percent and Basic Nursing Care Provided by the Nurse Aide at 24 percent. Oral option - 'The Written test can be taken in an oral form. During an Oral test, you will hear the questions read to you while reading and answering questions on the computer. You may replay questions as many times as needed.' It must be chosen on the application: 'This request cannot be made on the day of testing.' The oral form carries an extra section: 'the Oral test has an additional section of exam questions on Reading Comprehension. The Reading Comprehension Test has approximately 15 questions,' and 'Candidates must pass both the Reading Comprehension section and the Knowledge test section on the same day in order to pass the Oral test.' The regulation is the reason that option exists, and it also allows another language in narrow circumstances: the written component 'shall be given in English unless the aide will be working in a facility in which the predominant language is something other than English,' in which case it 'may be taken in the written predominant language used in the facility, dependent upon the availability of a translator who shall maintain the integrity of the examination' (LAC 48:I.10021.B); and 'A substitute examination, including an oral component, shall be developed for those nurse aides with limited literacy skills' containing all the written content plus 'a written reading comprehension portion' (LAC 48:I.10021.C). Clinical skills test - five skills, all of which must pass: 'You will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care... To pass the Clinical Skills test, you must pass all five skills. You are not required to perform the skill perfectly, but you are required to demonstrate competency of the skill.' There is no single fixed clock: 'Each test form has its own time limit based on the combination of skills being asked to perform.' Corrections are allowed mid-skill if announced, but not after a skill is finished. The regulation sets the same five-task structure and the way tasks are drawn: 'The skills demonstration of the competency evaluation program shall consist of a minimum performance of five tasks, all of which are included in the performance record. These five tasks shall be selected for each aide from a pool of evaluation tasks which have been ranked according to degree of difficulty. A random selection of tasks shall be made with at least one task from each degree of difficulty being selected' (LAC 48:I.10021.H), with examples running from making an occupied bed to 'responding to a demented resident who is calling out, yelling or indicating distress or anger.' Scheduling: 'First-time testers will be scheduled to take both the Clinical Skills Test and the Knowledge Test on the same day,' arriving at least 30 minutes early, and the test 'is scored at the test site.' No passing score for the state examination is published in any Louisiana source we checked - the regulation, the Department's pages and the Department-linked bulletin were all checked and none states one.",
   "fees": "The state charges nothing for the certification itself. No fee for certification, renewal or registry listing appears anywhere in LAC 48:I, Chapter 100 or on the Department's nurse aide pages, and the Department states that programs are free to approve as well: 'Fees not applicable (LDH does not charge fees for nurse aide training programs/schools seeking program approval.)' What a candidate pays is the testing fee, paid to the approved administrator. Prometric's published table (Candidate Information Bulletin for Louisiana, revision stamp 09102025, linked by the Department from its registry page): Newly Trained Tester - Written and Clinical Skills $125; Oral and Clinical Skills (includes Reading Comprehension Exam) $125. Lapsed/Other Candidate - Written and Clinical Skills $125; Oral and Clinical Skills $125. Re-tester - Written Test only $40; Clinical Skills Test only $85. Reciprocity Application Processing Fee $35. One cell in that table - the re-tester price for the Oral test only - could not be read from the published bulletin, so no figure for it is stated here. Payment terms, in the bulletin's words: 'Testing fees are paid to Prometric when the application is processed and must be paid with 3rd party/employer check, cashier's check, money order, or credit card.' Rescheduling costs money and lateness costs everything: '$25 fee if you reschedule at least 5 business days before your test. If you reschedule less than 5 business days before your test you will lose your test fee and be considered a no show for the exam.' Optional practice material, priced separately and not required by the state: 'The Written Nurse Aide Practice Exam contains 50 questions. The fee for each practice exam is $10. A super pack of all 3 practice exams is available for $25'; each Clinical Skill Readiness test is '$5 to $7 with a super pack of all skills available for $25.' LCTCS fees are not stated here. The Department names LCTCS as an equally approved administrator but publishes no price for it, and the LCTCS application site loads its content after the page opens, showing nothing but a loading screen to anything that reads the address itself - so no LCTCS figure was readable as of August 16, 2026 and none is asserted. Tuition for the 80-hour program is set by each approved school; the Department publishes a directory of approved schools but no prices - and if a facility employs you or has offered you a job when the program begins, it may not charge you for any part of it (LAC 48:I.10045.G).",
   "legal_basis": "[{\"citation\": \"La. Admin. Code tit. 48, Part I, Chapter 100 (Nurse Aide Training and Competency Evaluation Program), Louisiana Administrative Code edition of September 2025\", \"what_it_governs\": \"The whole Louisiana nurse aide scheme: definitions of certified nurse aide, trainee and approved setting; approval of training programs; the 80-hour curriculum and its competencies; trainee age, identification and pre-enrolment criminal history check; the competency evaluation and its attempt limits; the aide's own maintenance duty; the Louisiana Certified Nurse Aide Registry and employer checking duties; certification by reciprocity; employer responsibilities including the 60-day rule and the 12 hours of annual on-going training; disqualification of training programs; and the finding, notice-of-violation and informal-dispute-resolution process.\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"citation\": \"La. Admin. Code tit. 48, Part I, sections 10001 (Definitions) and 10011 (General Provisions)\", \"what_it_governs\": \"What a 'Certified Nurse Aide' is and the requirement that the person be 'listed as certified and in good standing on the Louisiana Certified Nurse Aide Registry (LCNAR)'; what counts as an 'approved setting'; the definitions of trainee, virtual classroom and real-time learning added in September 2025; departmental approval of all programs; the rule that a nursing facility may teach but may not administer the competency evaluation; and the requirement that clinical instruction occur in a nursing home or hospital-based skilled nursing unit.\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"citation\": \"La. Admin. Code tit. 48, Part I, sections 10015 (Training Curriculum/Program Approval) and 10019 (Training Program Responsibilities)\", \"what_it_governs\": \"The 80-hour minimum split 40 classroom and 40 clinical; the 16 hours of instruction required before any direct involvement with a resident; the full list of curriculum competencies including the annual one-hour CPR in-service; the minimum age of 16; trainee identification during clinical training; the four-hour clinical-site orientation that sits outside the 80 hours; the program's duty to run a statewide criminal history and sex-offender-registry check before accepting a trainee, the narrow disqualifying findings, and the protections for unrelated criminal history and for trainees too young for a state police check.\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"citation\": \"La. Admin. Code tit. 48, Part I, sections 10021 (Competency Evaluation) and 10013 (Certification Criteria for Nursing Professionals, Nursing Students and Military Personnel)\", \"what_it_governs\": \"Who may administer the examination; the English-language rule and its predominant-language exception; the substitute examination for limited literacy; the 30-day post-program testing rule for non-facility-based trainees and the three attempts within one year; the five-task skills demonstration drawn from a difficulty-ranked pool; the independence of the clinical examiner; and the documentation routes and three-year student recency rule for nurses, nursing students, foreign-trained nurses and military personnel, including the rule that someone trained but never tested in another state must test there or retrain in Louisiana.\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"citation\": \"La. Admin. Code tit. 48, Part I, sections 10025 (Nurse Aide Responsibilities), 10033 (Nurse Aide Registry - General Provisions), 10035 (Certification by Reciprocity) and 10045 (Employer Responsibilities)\", \"what_it_governs\": \"The aide's duty to keep contact details current and to perform at least eight paid hours of nursing or nursing-related service per 24 months, and the single retest inside two years of expiry; the contents of the registry including certification number and certified, recertified and expiration dates; the permanence of findings; the employer's duty to check the registry, the Louisiana adverse actions list and the federal exclusion list before hiring and monthly afterwards; the information a reciprocity applicant must file and the Department's verify-then-certify sequence; and the 60-day employment limit, the five-working-day employment and termination reporting rule, the 12 compensated hours of annual on-going training, and the no-charge and pro-rata reimbursement rules for training costs.\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"citation\": \"La. Rev. Stat. 40:1203.3 (Refusal to hire or contract; termination of employment; exceptions to hiring prohibition; appeal procedure; waiver)\", \"what_it_governs\": \"The 'non-hirable offense' schedule that LAC 48:I.10045.B.3 incorporates: the list of Title 14 offences and controlled-substance distribution offences barring employment of a nonlicensed person, the additional list for employers serving anyone under 21, felony theft and theft from an aged person or person with a disability above five hundred dollars, the duty to terminate immediately on discovering such a conviction, and the carve-outs for pre-August-2010 waivers, pardons, expungements, state-certified hospice attendants and peer support specialists.\", \"url\": \"https://www.legis.la.gov/legis/Law.aspx?d=964764\"}, {\"citation\": \"42 C.F.R. Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants), cited by the Department as the federal frame\", \"what_it_governs\": \"The federal requirements Louisiana's definition of a certified nurse aide points to - the Department's own definition turns on completing a program 'approved by the state as meeting the requirements of 42 CFR 483.151 - 42 CFR 483.154' or being 'determined competent as provided in 42 CFR 483.150(a) and (b)'. The Department links this subpart from its CNA Registry page as the federal regulation governing the program. The subpart's own text was not read as of August 16, 2026; nothing on this page is quoted from it, and the federal 75-hour floor is mentioned only as context for Louisiana's higher 80-hour figure.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Two approved administrators, both named by the Department: Prometric, and the Louisiana Community and Technical College System (LCTCS) college sites. The Department states it directly - 'LDH utilizes Prometric and Louisiana Community & Technical College System (LCTCS) college sites to administer the LA Nurse Aide Competency Evaluation. To be certified to the LA Nurse Aide Registry, nurse aide trainees must successfully complete the competency exam administered by Prometric or LCTCS' - and repeats it on the registry page: 'The Louisiana Department of Health (LDH) partners with Prometric and the Louisiana Community and Technical College System (LCTCS) to administer the Louisiana Nurse Aide Competency Evaluation exam.' Louisiana does not use the NNAAP examination that Credentia administers for many other states; the state-linked booklet is Prometric's own 'Candidate Information Bulletin, State of Louisiana, Certified Nurse Aide Evaluation Program.' The regulation keeps the administrator at arm's length from the school: 'Written or oral examinations shall be provided by an entity or organization approved by the department' (LAC 48:I.10021.A), the clinical portion in a facility-run program 'shall be administered by personnel not associated with the facility' (LAC 48:I.10021.J), and 'The examiner conducting the clinical competency evaluation for any individual trainee shall be approved by the department' (LAC 48:I.10021.K). One thing only Prometric does: the Department states that 'Prometric is the ONLY vendor that provides the following route: Route 8: Reciprocity.'",
   "training_hours": "80 hours total - 40 classroom hours and 40 clinical hours - with two further hour rules that sit outside that total. The state's own regulation states the minimum: 'The curriculum shall be a minimum of 80 hours in length, which includes 40 classroom hours and 40 clinical hours' (LAC 48:I.10015.A.2). The same section treats 80 as a floor a program may exceed: 'Each additional unit objective added to the approved curriculum, above the minimum 80 hours, shall be behaviorally-stated for each topic of instruction.' Before any resident contact: 'Facility and non-facility based training programs shall provide at least 16 hours of instruction prior to a trainee's direct involvement with a resident. The 16 hours of instruction shall be devoted to areas listed in Subsection C of this Section' (LAC 48:I.10015.B.2) - those 16 hours are part of the 80, aimed at the listed competencies. On top of the 80: 'Each nurse aide training program shall provide all trainees with an orientation of the clinical training site of at least four hours that is not included in the required 80 hours of core curriculum' (LAC 48:I.10019.C), covering the facility's organisational structure, policies and procedures, philosophy of care, resident population, employee rules, and 'what constitutes abuse, neglect, and misappropriation, including the consequences imposed if found guilty of such.' So a Louisiana trainee sits through at least 84 scheduled hours even though the curriculum minimum is 80. Louisiana's 80 is above the federal floor of 75 hours, and the Louisiana regulation states its own number rather than reciting the federal one.",
   "lapse_rule": "Certification expires exactly two years after the certification date, and the registry then shows the aide as 'Not Certified'. Louisiana's way back is a single retest inside a two-year window, and after that, full retraining. The regulation: 'If a nurse aide does not have proof of the required eight hours of paid employment in an approved setting in a 24-month period needed for recertification, he/she may retest with the two years immediately following the expiration. If the nurse aide fails to retest within the allotted time period, they shall retrain' (LAC 48:I.10025.C). The Department's operational version, which is stricter than it first reads: 'Aides have one opportunity to test for recertification. Aides who fail to test during this two-year period are required to RETRAIN'; 'Aides who do not pass both parts of the test (written/oral or skills) have to RETRAIN'; and 'Aides are required to schedule the test and pay for the test.' The Department-linked bulletin matches: a candidate whose certification lapsed less than 24 months 'will have only one attempt to pass the Clinical Skills exam and one attempt to pass the Written or Oral exam before you are required to re-train.' How to know if you still qualify: the registry itself carries the deadline. 'Retesting is permitted within two (2) years of the certification expiration date. To determine whether you are still eligible, please review your \"Retest Required By\" date on the Louisiana Department of Health (LDH) online Nurse Aide Registry.' The Department spells out the four outcomes: status 'not certified' with an unexpired retest date and no retest used means you may retest, after printing 'the registry page which verifies your status and certification period' to present with photo identification at the test site; status 'not certified' with the retest date passed means retraining; having already retested and failed either part means retraining; and a 'certified' status with a blank retest date means you are not eligible to retest because nothing has lapsed. The Department states the bright line in one sentence: 'You must retrain if it is greater than 2 years since expiration, or have unsuccessfully passed the retest/recertification exam.' Lapse is not the same as a finding. A substantiated finding of abuse, neglect or misappropriation is recorded against the registry entry and does not expire: 'Record of the occurrence and associated findings shall remain permanently on the registry' (LAC 48:I.10033.D). The Department-linked bulletin gives the only three exits: findings 'will be removed only when: The findings have been made in error; An individual has been found not guilty in a court of law; or The state is informed of a registrant's death.' A nurse aide under investigation 'is given a hearing and has an opportunity to rebut findings in the Registry,' and an aide who believes the accusation is wrong may request an informal dispute resolution 'within 15 calendar days after the delivery or documented attempted delivery of the department's notice of violation' (LAC 48:I.10061.A).",
   "reciprocity": "Louisiana calls it reciprocity, runs it as an application with a fee, and - unusually - hands the whole process to one vendor. The Department is explicit that it does not handle it: 'For questions related to RECIPROCITY (transferring your certification from another state), please contact Prometric directly, as our office is unable to assist with these requests.' It repeats that Prometric alone runs it: 'Prometric is the ONLY vendor that provides the following route: Route 8: Reciprocity - processing of transfer of active CNA from another state to Louisiana Nurse Aide Registry. Testing is not required.' What the applicant must be: 'You must have an active certification and be in good standing in all states where you are currently certified' (Department), and the Department-linked bulletin's Route 8 requires the candidate to 'Be an active certified nurse aide in good standing in another state.' The processing fee published in that bulletin is $35, and no examination is required. What the regulation requires to be filed (LAC 48:I.10035.A): name; Social Security number; 'the certification number in the other state'; 'the address of the other state's registry'; former place of employment; the dates of employment and termination; e-mail address; a copy of the Social Security card; and 'a copy of his/her official Louisiana identification, such as a driver's license, identification card, etc.' ⚠ That last item is not absolute — see the Department's own procedure below, which accepts a military ID instead and waives the Louisiana ID altogether for an applicant living within thirty miles of the state. The Department then verifies before listing: 'After verification of certification in the other state, the registry shall certify the aide in Louisiana. Likewise, the registry will be responsible for granting reciprocity to other states' (LAC 48:I.10035.B). The trap for people trained elsewhere but never tested: reciprocity is for certifications, not for coursework. 'An individual who trained in another state but did not test, shall test and certify to the registry in that state before transferring to Louisiana, or shall retrain and test in Louisiana' (LAC 48:I.10013.F). The Department's own procedure document adds a carve-out the regulation does not have. LDH publishes a one-page 'Reciprocity Procedure' (revision stamp Rev09112025) that walks the route in its own words: 'Fill out the application found under the Candidate Resources section of our website (www.prometric.com/nurseaide/la), selecting the Route 8 Reciprocity option. Submit the application form, $35 application fee, and a copy of your SSN card and government issued Louisiana ID or military ID to Prometric. If your address is within 30 miles of LA, you will not be required to obtain a Louisiana ID to process your reciprocity.' So a military ID is accepted in place of the Louisiana identification the regulation lists, and an applicant living within thirty miles of the state line does not have to obtain one at all. The same document confirms the $35 fee — a third official statement of it — and ends the sequence with the state rather than the vendor: 'Once the application has been verified, Prometric will send your information to LDH for final review and approval to be placed on the Louisiana Registry.' Going the other way, the Department-linked bulletin puts the burden on the aide: 'If you are a nurse aide moving from Louisiana to another state, you must contact the Registry of that state to see if your CNA status can be transferred to that state as requirements vary from state to state.' And Louisiana no longer writes letters for you: 'The Louisiana Nurse Aide Registry will no longer accept or process requests for written verification of Certified Nurse Aide (CNA) status' — what you produce instead is the printable verification from the registry lookup. No processing time for a reciprocity application is stated on this page because none appears in any of these sources, the Department's own procedure document included.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Louisiana Department of Health, Health Standards Section - CNA Registry. The Department's main nurse aide page. Establishes 'Nurse aides are certified for 2 years, beginning with the certification date'; the eight-hours-per-24-months maintenance rule and the list of approved settings; 'Effective July 1, 2018, all trainees must successfully pass the competency examination to be certified on the Louisiana Nurse Aide Registry'; 'The Louisiana Department of Health (LDH) partners with Prometric and the Louisiana Community and Technical College System (LCTCS) to administer the Louisiana Nurse Aide Competency Evaluation exam'; the reciprocity referral 'please contact Prometric directly, as our office is unable to assist with these requests'; 'CNAs cannot report their own work history'; the Social-Security-number-with-dashes search instruction for the online registry; the retesting window; and the links to the current LAC Chapter 100 text and to the federal 42 CFR Part 483 Subpart D.\", \"url\": \"https://ldh.la.gov/health-standards-section/cna-registry\"}, {\"label\": \"Louisiana Department of Health, Health Standards Section - Nurse Aide Training and Certification Maintenance. Establishes the Department's own definition of a certified nurse aide by reference to 42 CFR 483.150-483.154; 'Fees not applicable (LDH does not charge fees for nurse aide training programs/schools seeking program approval.)'; the certification-maintenance rule and approved settings, including that hours outside nursing homes are not required to be reported; 'Private sitting or staffing agency work do not qualify as approved settings'; the one-retest rule and 'Aides who fail to test during this two-year period are required to RETRAIN'; the four-outcome retest eligibility test keyed to the registry's 'Retest Required By' date; and the 30-day emergency allowance for out-of-state aides.\", \"url\": \"https://ldh.la.gov/page/nurse-aide-cna-training-and-certification\"}, {\"label\": \"Louisiana Department of Health - LDH Approved CNA Certification Testing Vendors. Establishes 'LDH utilizes Prometric and Louisiana Community & Technical College System (LCTCS) college sites to administer the LA Nurse Aide Competency Evaluation'; the eight eligibility routes and what each covers; 'Prometric is the ONLY vendor that provides the following route: Route 8: Reciprocity ... Testing is not required'; the requirement of an LDH approval-to-test application for the nurse, nursing-student and military routes; the regional and in-facility test-site structure including the goal that candidates travel no more than an hour; and the accommodation packets.\", \"url\": \"https://ldh.la.gov/page/3013\"}, {\"label\": \"La. Admin. Code tit. 48, Part I, Chapter 100 (Nurse Aide Training and Competency Evaluation Program), Louisiana Administrative Code September 2025 edition, published by the Department. The controlling regulation, and the source of every hour figure, attempt limit, age, registry content and employer duty stated on this page - including 'The curriculum shall be a minimum of 80 hours in length, which includes 40 classroom hours and 40 clinical hours' (section 10015.A.2), the 16 pre-contact hours (10015.B.2), the four-hour orientation outside the 80 (10019.C), 'Each nurse aide trainee shall be at least 16 years old' (10019.A), the three attempts within one year (10021.E), the eight paid hours per 24 months (10025.B), the two-year retest window (10025.C), the registry contents and permanence of findings (10033), the reciprocity filing list (10035) and the 60-day employment limit and 12 compensated annual training hours (10045).\", \"url\": \"https://ldh.la.gov/assets/Medicaid/hss/docs/HSS_Rule_Making/LAC/NATCEP_LAC_9.24.25.pdf\"}, {\"label\": \"Prometric - Candidate Information Bulletin, State of Louisiana, Certified Nurse Aide Evaluation Program (revision stamp 09102025), linked by the Department from its CNA Registry page as the source of 'detailed instructions, an exam content outline, sample test questions, and a paper competency evaluation exam application'. Establishes the eight eligibility routes and their attempt limits; 'The Knowledge Test consists of 60 multiple-choice questions ... You will have 90 minutes'; the oral option and its approximately 15-question Reading Comprehension section; the five-skill Clinical Skills test with Handwashing and Indirect Care always scored; the fee table ($125 newly trained or lapsed, $40 written-only re-test, $85 clinical-skills-only re-test, $35 reciprocity processing); the $25 rescheduling fee and the loss of the fee inside five business days; 'Your Nurse Aide Registry certificate is valid for two years from the time of issue'; the renewal eligibility statement; and the three circumstances in which a registry finding is removed.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/LACNA-Candidate-Information-Bulletin.pdf\"}, {\"label\": \"Louisiana Nurse Aide Registry public lookup (the Department's 'online Registry'). The live search form whose own fields establish the search options listed under Verify a license on this page, and which states on its face that 'Expiration for all CNAs is exactly two years from Certification Date', that the Direct Service Worker registry moved to the Louisiana adverse actions site effective October 1, 2018, and that 'the old look-up site will remain active for verification of certification status of certified nursing assistants.'\", \"url\": \"https://tlc.dhh.la.gov/\"}, {\"label\": \"Louisiana Department of Health, Health Standards Section - Nurse Aide Training Programs. The Department's page for new and existing approved training programs, and the route to the published directory of approved Louisiana nurse aide training schools.\", \"url\": \"https://ldh.la.gov/health-standards-section/nurse-aide-training-programs\"}, {\"label\": \"La. Rev. Stat. 40:1203.3, Louisiana State Legislature. The non-hirable-offense schedule incorporated by LAC 48:I.10045.B.3 - 'no employer shall hire any licensed ambulance personnel or nonlicensed person when the results of a criminal history check reveal' conviction of the listed offences, the additional list for employers serving people under 21, the felony-theft threshold of five hundred dollars, the immediate-termination duty, and the waiver, pardon, expungement, hospice-attendant and peer-support-specialist carve-outs.\", \"url\": \"https://www.legis.la.gov/legis/Law.aspx?d=964764\"}, {\"label\": \"Louisiana Department of Health — Reciprocity Procedure (revision stamp Rev09112025), the Department's own one-page walkthrough of Route 8. Establishes the filing package ('Submit the application form, $35 application fee, and a copy of your SSN card and government issued Louisiana ID or military ID to Prometric'), the thirty-mile carve-out ('If your address is within 30 miles of LA, you will not be required to obtain a Louisiana ID to process your reciprocity'), the closing state-approval step ('Once the application has been verified, Prometric will send your information to LDH for final review and approval to be placed on the Louisiana Registry'), and the end of written verifications ('The Louisiana Nurse Aide Registry will no longer accept or process requests for written verification of Certified Nurse Aide (CNA) status'). It states no processing time.\", \"url\": \"https://ldh.la.gov/assets/hss/CNA/ReciprocityProcedure.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/la-cna/"
  },
  {
   "page_id": "ma-cna",
   "state": "Massachusetts",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Massachusetts Department of Public Health (DPH), Bureau of Health Professions Licensure - Nurse Aide Registry Program. The Department describes its own role in one sentence: 'The Nurse Aide Registry Program reviews training and competency evaluation programs, oversees the Massachusetts state competency evaluation, and maintains a registry of nurse aides,' and adds that it 'oversees the Nurse Aide Registry and all aspects of nurse aide certification in Massachusetts.' No Board of Nursing is involved - the Board of Registration in Nursing licenses nurses; the nurse aide credential sits with the Department under M.G.L. c. 111, sec. 72J, which directs that 'The department shall, subject to appropriation, establish and maintain a registry of all individuals who have met the federal requirements for competency contained in 42 USC sec. 1396r and have been certified as nurse aides for employment in a facility.' Testing is delivered under contract: 'The Massachusetts Department of Public Health (DPH) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide nurse aide testing and scoring services.'",
   "board_url": "https://www.mass.gov/orgs/nurse-aide-registry-program",
   "application_url": "https://www.mass.gov/info-details/learn-how-to-become-a-certified-nurse-aide-in-massachusetts",
   "renewal_cycle": "Every 24 months, and it turns on eight hours of paid work rather than on a course or a fee. The state-linked handbook states the rule: 'To maintain your eligibility to work, you must renew it every 24 months. To be eligible to renew, you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous 24 months. Nurse aides with misconduct restrictions on the Registry are not eligible for renewal.' The word consecutive is the handbook's, not the Department's, and the two are recorded rather than reconciled: on the handbook's wording Massachusetts asks for eight consecutive hours rather than eight hours accumulated, while the Department's own renewal page states the same test without the word. The Department's own instruction: 'If your certification is about to expire, and you have worked for pay as a nurse aide for at least eight hours performing nursing-related duties within the past two years, complete the Renewal Application process online on the Department of Public Health Licensing System.' Where renewal happens changed in late 2023 and the Department flags it twice: 'Beginning December 4, 2023, CNAs who are eligible to renew must use the new Health Profession Licensing System to renew their certification,' with a how-to video and a user guide published alongside it. Personal-information changes moved to the same system: 'updating of CNA personal information (name, address, etc.) should be completed through the new Health Profession Licensing System.' No continuing education and no renewal fee appear in any Massachusetts source we checked. After results or a renewal, allow lag: 'If you have just completed the Nurse Aide Certification Exam, please allow at least three weeks to receive your test results and for your information to be updated on the license verification website.'",
   "ce_hours": "No continuing education is required to renew a Massachusetts CNA listing. Renewal turns on eight consecutive hours of paid nurse aide work in the previous 24 months and nothing else; no course, contact-hour or in-service requirement for the individual appears in 105 CMR 156.000, on the Department's Nurse Aide Registry Program, become-a-CNA, renewal, employer or training-program pages, or in the state-linked candidate handbook - all checked. Two obligations that sit on someone else. First, the facility owns any training beyond the state minimum: 'Facilities requiring nurse aides to perform tasks not included in the minimum standard curriculum shall ensure nurse aides are trained to perform these tasks and have successfully demonstrated their ability to perform these tasks' (105 CMR 156.300(C)), and 'The facility shall ensure nurse aides perform only those tasks for which they have been trained and for which they have successfully demonstrated their ability to correctly perform these tasks' (105 CMR 156.100(D)). Second, the 24 contact hours that appear in the regulation belong to instructors, not to aides - they are one of the ways a primary instructor may show teaching capability (105 CMR 156.220(A)(2)). The Department's April 2026 curriculum memo confirms the negative for existing aides in terms: 'CNAs who are currently in good standing on the Massachusetts Nurse Aide Registry will not be required to complete additional training.'",
   "exam": "Two parts, both required: a multiple-choice knowledge exam and a hands-on skill exam observed by a registered nurse. The state-linked handbook: 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts of the exam and meet all other requirements of the Massachusetts Department of Public Health (DPH) to be identified and listed on the Massachusetts Nurse Aide Registry.' Knowledge exam - 60 questions, 60 minutes: 'The Knowledge Exam consists of 60 multiple-choice questions,' and 'You will have a maximum of sixty (60) minutes to complete the 60-question knowledge exam.' The published Massachusetts blueprint distributes those 60 questions across twelve subject areas: Role and Responsibility 9, Basic Nursing Skills 8, Disease Process 7, Resident Rights 6, Safety 6, Communication 5, Infection Control 4, Mental Health 4, Personal Care 4, Care Impaired 3, Aging Process and Restorative Care 2, and Data Collection 2. An audio version reads the questions aloud while the candidate reads along; it must be requested before the testing fee is paid and costs $10 more. A remotely proctored knowledge exam is available and requires two devices, a computer and a smartphone joined to a video link at least 20 minutes before the start. Skill exam - three or four tasks in 40 minutes: 'Each of your randomly selected three (3) or four (4) tasks will have scenarios associated with them. The scenarios will be read to you by the RN Test Observer immediately before you are asked to do each task,' and 'You will be allowed forty (40) minutes to complete your three or four tasks,' with a warning timer at 15 minutes remaining. One mandatory task is assigned and the rest are drawn at random: 'You will also receive an additional two (2) or three (3) randomly selected tasks from the Skill Task listing.' Hand hygiene is scored inside the mandatory task rather than as a separate item: 'Handwashing with soap and water is required for each mandatory task and must be demonstrated at the end of each.' Steps may be corrected during the allotted time, and 'The skill task steps are not order dependent.' Test-day conditions are strict and forfeit fees: candidates must be in the waiting area 20 minutes before the start time or be recorded a no-show with fees lost; full clinical attire - scrubs and closed-toed shoes - is required for in-person events, and 'You will not be admitted for testing if you are not wearing clinical attire and the appropriate shoes'; smartwatches, smart glasses, fitness monitors and Bluetooth devices are barred, though a standard watch with a second hand is allowed; and identification must be an original, non-expired, signature-bearing United States government-issued photo ID, with digital wallet versions expressly rejected. Candidates taking both components on-site should 'Plan to be at the test site for up to five (5) hours'. Attempts - four on the knowledge test, three on the skills test. The Department states it plainly: 'You may take the knowledge portion of the test up to 4 times. You may take the clinical portion of the test up to 3 times.' The handbook states the consequence: 'If you fail the knowledge component four (4) times or the skills component three (3) times, you must complete another Massachusetts Department of Public Health (DPH) approved training program to be eligible to schedule testing.' No passing score for either component is published in any Massachusetts source we checked - the regulation, the Department's pages and the state-linked candidate handbook were all checked.",
   "fees": "No state fee for the registry listing or for renewal is published anywhere in 105 CMR 156.000 or on the Department's Nurse Aide Registry pages, and none was found as of August 16, 2026. What a candidate pays is the testing fee, and it goes to the Department's contracted testing service, not to the Commonwealth. The published testing prices, from the Massachusetts Nurse Aide Candidate Handbook the Department links (the May 2026 edition, Version 7.0): knowledge exam $30.00, skill exam $70.00, both together $100.00. The audio version of the knowledge exam adds $10 - the handbook shows the arithmetic itself, '$30.00 Knowledge Exam fee + $10.00 for the Audio Version = $40.00'. Retakes are priced the same per component: the knowledge retake table covers '2nd, 3rd & 4th Attempt(s)'. Many candidates pay nothing because the school already did: 'Before scheduling a test, verify with your instructor whether the training program has already prepaid for it.' Two charges that catch people out. Refunds: a timely request 'qualif[ies] for a full refund of any testing fees paid minus a $35 refund processing fee', requests must be made within 30 days of payment, and the deadline runs to the close of business one full business day before the event - miss it, or arrive late, or arrive out of clinical attire, and you are a no-show with the fee forfeited. Test review: 'There is a $25 non-refundable test review deposit fee', refunded only 'If, after investigation, the review finding is in your favor.' Tuition for the training program is set by each approved provider and is not published by the Department. No fee is stated for the training waiver application or for the reciprocity application in any Massachusetts source we checked, and none is asserted here.",
   "legal_basis": "[{\"citation\": \"Mass. Gen. Laws ch. 111, sec. 72J (Registry; establishment; documented findings of patient or resident abuse)\", \"what_it_governs\": \"The statutory basis for the whole credential: the Department's duty to 'establish and maintain a registry of all individuals who have met the federal requirements for competency contained in 42 USC sec. 1396r and have been certified as nurse aides for employment in a facility'; the bar on a facility other than a rest home hiring anyone not listed as having demonstrated competency; the registry's contents including documented findings of abuse, mistreatment, neglect or misappropriation against nurse aides, home health aides and homemakers together with the individual's own disputing statement; the duty on all facilities, home health agencies and homemaker agencies to contact the registry before hiring; the notice-and-hearing procedure before a finding is made; the rule that neglect may not be found where the individual shows it was caused by factors beyond their control; and the Department's power to suspend the right to work.\", \"url\": \"https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter111/Section72J\"}, {\"citation\": \"105 C.M.R. 156.000 (The Training of Nurse Aides in Long-term Care Facilities), Massachusetts Department of Public Health; regulatory authority M.G.L. c. 111, sec. 72W\", \"what_it_governs\": \"Scope and definitions including 'nurse aide', 'contact hour' and 'document of completion'; the facility's duty to ensure training within 90 days of hire and certification within four months, and the three exemptions from post-hire training that also function as the training-waiver categories; staffing-ratio limits for trainees; the lapse rule that returns an aide with no qualifying employment in the prior two years to new-employee status; approval, renewal and withdrawal of approval for training providers; the primary instructor's qualifications and the one-to-25 classroom and one-to-ten clinical ratios; the 75-hour minimum curriculum and the requirement that facility-specific tasks be trained on top of it; curriculum approval; the document of completion and the duty on facility administrators to accept it; and the Department's competency evaluation duty under 42 CFR 483.154.\", \"url\": \"https://www.mass.gov/regulations/105-CMR-15600-the-training-of-nurses-aides-in-long-term-care-facilities\"}, {\"citation\": \"105 C.M.R. 155.000 (Patient and Resident Abuse Prevention, Reporting, Investigation, Penalties and Registry), Massachusetts Department of Public Health\", \"what_it_governs\": \"The abuse-prevention and registry-findings side of the scheme, which the Department lists first among the regulations governing the Nurse Aide Registry and cites as the source of the narrow exception to the hiring prohibition at 105 CMR 155.014(A)(2). This page cites it as the companion regulation the Department names; its full text was not read as of August 16, 2026, and nothing here is quoted from it.\", \"url\": \"https://www.mass.gov/regulations/105-CMR-15500-patient-and-resident-abuse-prevention-reporting-investigation-penalties-and-registry\"}, {\"citation\": \"42 C.F.R. 483.150-483.158 and 42 U.S.C. 1396r, cited by Massachusetts as the federal frame\", \"what_it_governs\": \"The federal requirements Massachusetts builds on. The statute defines Registry membership by reference to 'the federal requirements for competency contained in 42 USC sec. 1396r'; the regulation ties the Department's competency evaluation to 42 CFR 483.154 and the acceptance of out-of-state training to programs 'approved by that state under 42 CFR 483.151'; and the Department's public list of governing law names 42 CFR 483.12, 483.35, 483.95, 483.150, 483.151, 483.152, 483.154, 483.156 and 483.158. The federal text itself was not read as of August 16, 2026; nothing here is quoted from it, and the federal 75-hour floor is named only because the Department's own April 2026 memo names it.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "D&S DIVERSIFIED technologies, LLP (D&SDT) - Headmaster, LLP, under contract to the Department. The state-linked candidate handbook states the appointment: 'The Massachusetts Department of Public Health (DPH) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide nurse aide testing and scoring services.' The Department routes every candidate there - 'To request an application for the Nurse Aide Competency Evaluation Program or to schedule your examination, please visit D&S Diversified Technologies (D&S)' - and links the vendor's Massachusetts nurse aide page by name from its own training-program and become-a-CNA pages. Massachusetts does not use the NNAAP. The examination is built on a state-specific test plan: 'Questions are selected from subject areas based on the Massachusetts Department of Public Health (DPH)-approved Massachusetts test plan and include all required categories defined in federal regulations.' Scheduling and results run through the vendor's TestMaster Universe (TMU) system at mc.tmutest.com. The Department keeps the regulatory half: '156.500: Competency Evaluation. The Department shall conduct competency evaluations in accordance with the guidelines of the Department, consistent with federal standards for evaluating the competency of individuals completing nurse aide training as specified at 42 CFR 483.154' (105 CMR 156.500). Three other functions were moved to the vendor in recent years - reciprocity applications 'Beginning December 4, 2023', training-waiver applications, and test-review requests - while renewal and personal-information changes moved the opposite way, to the Department's own Health Profession Licensing System on the same date. The vendor is also where the revised exam will land: the Department's April 2026 curriculum memo says the updated curriculum is 'intended to align with planned revisions to the state Nurse Aide credentialing exam. Revised exams are expected to roll out in early 2027.'",
   "training_hours": "75 hours minimum today, with a published increase to 87 hours announced but not yet in the regulation. The operative number: '(A) Each nurse aides training course shall be a minimum of 75 hours and shall include all modules of the minimum standard curriculum as prescribed in guidelines from the Department' (105 CMR 156.300(A)). That is the federal floor and nothing higher; the regulation states no classroom-versus-clinical split, and no split is published on any Department page we checked. Curriculum content lives outside the regulation, in the Department's 'minimum standard curriculum' guidelines and now in the State-Approved CNA Curriculum Framework. The announced change, in the Department's own words: a memo to DPH Nurse Aide Training Programs from the Executive Office of Health and Human Services and DPH dated April 6, 2026 states that 'Training providers are also expected to align programs to new minimum training hours. DPH will be increasing the required minimum training hours from the federal standard of 75 hours to 87 hours, including 21 hours of supervised practical training. Many approved programs already exceed this minimum training hour threshold and will continue to have discretion to do exceed the minimum hours.' The memo also says 'Revised exams are expected to roll out in early 2027' and that 'Additional detailed guidance will be issued throughout 2026.' So which applies? The 75-hour figure is the one in the regulation as published; the 87-hour figure is stated by the Department as a forthcoming requirement for training providers, with no amended text of 105 CMR 156.300 published alongside it. Both are official Massachusetts statements and both are reported here rather than reconciled. Anyone enrolling should ask their program which figure it is built to. The memo also settles one thing for existing aides: 'CNAs who are currently in good standing on the Massachusetts Nurse Aide Registry will not be required to complete additional training. Additionally, Massachusetts Home Health Aides will not be required to take action.' What the framework adds to content rather than hours: expanded material on behavioural and mental health, community inclusion, care of LGBTQ+ older adults, person-centred care and cross-setting caregiving skills, aimed at home-based care, long-term care, assisted living and community-based settings. The Commonwealth is also building a no-cost Learning Management System with 'More than 40 hours of knowledge-based content' in English, Spanish and Haitian Creole, 'Designed to supplement in-person skills training' and offered free to DPH-approved programs that opt in. A separate hour rule worth knowing: training beyond the minimum standard curriculum is the facility's job, not the program's - 'Facilities requiring nurse aides to perform tasks not included in the minimum standard curriculum shall ensure nurse aides are trained to perform these tasks ... Training for such tasks, including training for tasks related to special resident populations, shall be in addition to the minimum standard curriculum' (105 CMR 156.300(C)).",
   "lapse_rule": "Massachusetts has an unusually generous route back for someone who never stopped working, and a hard reset for everyone else. The work-experience route: 'If your nurse aide certification has expired, you may be able to renew your certification through your work experience. In order to be eligible, you must be currently employed as a nurse aide and have worked from before your certification expired to the present with no break in employment. If you are not currently employed or had a break in employment, you may need to retake the nurse aide certification test.' The Department directs anyone in that position to contact the Registry, and points to the vendor's Massachusetts page for testing details. The hard reset is in regulation and is broader than a test: 'An individual whose certification as a nurse aide has lapsed, and who has not been employed by either a long-term care facility or a temporary nursing agency as a nurse aide or licensed nurse at a long-term care facility at some point in the two years prior to re-commencing employment as a nurse aide shall be considered a new employee, and is required to repeat training and obtain certification as a nurse aide in accordance with 105 CMR 156.100' (105 CMR 156.120(B)). Note what counts: employment as a nurse aide OR as a licensed nurse, at a long-term care facility or a temporary nursing agency. Misconduct is a separate and heavier track. The Department sets out what each status permits: 'If you have been subject to probation as an alternative sanction, you may work during this time in accordance with the terms of your probation. In the case of suspension, you may not work as a CNA during the period of your suspension. If there has been a final finding against you, you may not work as a CNA.' Registry statuses an employer will see are Current, Finding, Case Pending, Expired and Inactive, and only Current lets a hire proceed. Getting a finding removed - one path for neglect, a much narrower one for the others. 'If you have one finding of neglect entered on the Nurse Aide Registry, and go the subsequent year without any incidents, you are eligible to petition the Department of Public Health for the removal of the neglect finding. Requests for removal of findings of neglect must be made in writing' to the Nurse Aide Registry in Marlborough. 'Findings of abuse or misappropriation may also be removed but only if you are found Not Guilty in a court of law of the conduct that was the basis for your abuse or misappropriation findings.' The statute supplies the due-process frame: the Department acts 'after notice to the nurse aide ... and a reasonable opportunity for a hearing for the individual to rebut such allegations', and it 'shall not make a finding that an individual has neglected a patient or resident if the individual demonstrates that such neglect was caused by factors beyond the control of the individual' (M.G.L. c. 111, sec. 72J).",
   "reciprocity": "Massachusetts runs reciprocity through its testing contractor, and the eligibility test has a third limb most states do not have. The three conditions, stated identically by the Department and by the state-linked handbook - you must be a CNA 'Who is certified in another state', 'Whose certification is current and in good standing', and 'Who has never been certified in Massachusetts.' That last one matters: a former Massachusetts CNA cannot come back through reciprocity and is handled as an expired-certification case instead. Where it is filed: 'Beginning December 4, 2023, the reciprocity application process should be completed through D&S Diversified Technologies (D&S),' using the vendor's Massachusetts reciprocity form. No fee for the reciprocity application is published in any Massachusetts source read for this page. How long it takes, and the risk an employer carries meanwhile: 'You should verify the CNA with both the Massachusetts Registry and the state registry through which the CNA is currently certified. You may also want to confirm when the reciprocity application was submitted, as the applications typically take 15 days to process. The regulations allow the aide to work for a facility for no more than 4 months if the aide qualifies to apply for reciprocity; however, please note that you would be hiring under risk, as we cannot guarantee the approval of reciprocity within the 4 month period.' A separate, adjacent route for someone whose out-of-state credential does not fit reciprocity is the training waiver, which excuses the Massachusetts training program but not the Massachusetts examination - available to someone currently certified in another state, someone who completed a nurse aide training program approved by another state under 42 CFR 483.151, or someone who completed a clinical course in an approved school of nursing that included hands-on care skills from the minimum standard curriculum (105 CMR 156.100(A)(2)). Going the other way, no Massachusetts source read for this page describes an outbound verification service or its cost.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Massachusetts DPH, Bureau of Health Professions Licensure - Nurse Aide Registry Program. The program's home page. Establishes the Department's own description of its role - 'The Nurse Aide Registry Program reviews training and competency evaluation programs, oversees the Massachusetts state competency evaluation, and maintains a registry of nurse aides' - the contact details for the Registry, and the routing to the become-a-CNA, renewal, training-sites, verification, complaint, training-program, employer, laws-and-regulations and Certified Medication Aide pages.\", \"url\": \"https://www.mass.gov/orgs/nurse-aide-registry-program\"}, {\"label\": \"Massachusetts DPH - Learn how to become a certified nurse aide in Massachusetts. Establishes the training, waiver, testing and reciprocity path: the pointer to the interactive map of approved training sites; 'Specific waiver provisions are available for applicants that can verify they meet the qualifications listed at 105 CMR 156.100'; 'you must apply to schedule an examination ... please visit D&S Diversified Technologies (D&S)'; 'As of December 2, 2024, the Massachusetts nurse aide certification exam is available in English, Spanish, Chinese, and Haitian Creole'; the three-week wait for results and Registry appearance; 'The Department is not able to share test results with individuals by phone'; 'You may take the knowledge portion of the test up to 4 times. You may take the clinical portion of the test up to 3 times'; and the three reciprocity conditions with the note that 'Beginning December 4, 2023, the reciprocity application process should be completed through D&S Diversified Technologies (D&S).'\", \"url\": \"https://www.mass.gov/info-details/learn-how-to-become-a-certified-nurse-aide-in-massachusetts\"}, {\"label\": \"Massachusetts DPH - Renewal information for Massachusetts certified nurse aides. Establishes the renewal rule ('if you have worked for pay as a nurse aide for at least eight hours performing nursing-related duties within the past two years, complete the Renewal Application process online on the Department of Public Health Licensing System'); the December 4, 2023 move to the Health Profession Licensing System for renewal and for personal-information changes; the expired-certification work-experience route and its no-break-in-employment condition; and the findings regime - what probation, suspension and a final finding permit, the one-year petition route for a single neglect finding, and the rule that findings of abuse or misappropriation 'may also be removed but only if you are found Not Guilty in a court of law'.\", \"url\": \"https://www.mass.gov/info-details/renewal-information-for-massachusetts-certified-nurse-aides\"}, {\"label\": \"Massachusetts DPH - Nurse Aide Registry information for employers. Establishes the pre-employment verification procedure against Check-A-License and what each status means ('Current' proceed; 'Finding', 'Case Pending', 'Expired', 'Inactive' do not); the record-keeping expectation that facilities retain timestamped verification PDFs with the aide's CORI check; the statutory hiring prohibitions and the 105 CMR 155.014(A)(2) exception; and the special-circumstances windows - 90 days without training, four months without the test, four months while a waiver is pending, and four months while reciprocity is pending, with the note that reciprocity applications 'typically take 15 days to process'.\", \"url\": \"https://www.mass.gov/info-details/nurse-aide-registry-information-for-employers\"}, {\"label\": \"Massachusetts DPH - Check Nurse Aide Certification. The Department's step-by-step instructions for the verification site, and the source of the search options listed under Verify a license on this page, including the certification-number format 'CNA-12345' and the method for obtaining a list of all certified nurse aides.\", \"url\": \"https://www.mass.gov/how-to/check-nurse-aide-certification\"}, {\"label\": \"Massachusetts DPH - Information for Nurse Aide Training Programs. Establishes the announcement of the new CNA Curriculum Framework and the link to the EOHHS memo; the four-language testing statement and the pointer to the candidate handbook; the process for becoming a DPH-approved Nurse Aide Training Program through the Health Professions Licensing System; the rule that 'DPH must approve all clinical sites. For sites to be approved, they must be a level II or level III long-term care facility in good standing'; that 'DPH does not approve certification or continuing education units (CEUs) for educational CNA workshops'; and the full required equipment, linen and resource lists for a training program.\", \"url\": \"https://www.mass.gov/info-details/information-for-nurse-aide-training-programs\"}, {\"label\": \"EOHHS and DPH memo to DPH Nurse Aide Training Programs, 'New Certified Nurse Aide (CNA) Curriculum Framework', dated April 6, 2026 (page last updated 2026-04-07). The source of the announced hour increase - 'DPH will be increasing the required minimum training hours from the federal standard of 75 hours to 87 hours, including 21 hours of supervised practical training' - plus 'Revised exams are expected to roll out in early 2027', the Direct Care Worker Career Pathway Initiative framing, the expanded content areas (behavioural and mental health, community inclusion, care of LGBTQ+ older adults, person-centred care, cross-setting caregiving skills), the free Learning Management System with 'More than 40 hours of knowledge-based content' in three languages, and the assurance that 'CNAs who are currently in good standing on the Massachusetts Nurse Aide Registry will not be required to complete additional training.'\", \"url\": \"https://www.mass.gov/doc/eohhs-memo-new-certified-nurse-aide-cna-curriculum-framework\"}, {\"label\": \"105 C.M.R. 156.000: The Training of Nurse Aides in Long-term Care Facilities (Department of Public Health regulation, published by Mass.gov with the full text as a downloadable PDF). The source of the 75-hour minimum, the definitions of nurse aide and contact hour, the 90-day and four-month employer windows, the three post-hire training exemptions that double as the waiver categories, the two-year lapse-to-new-employee rule, training-provider approval and renewal, primary-instructor qualifications and the one-to-25 and one-to-ten ratios, the document of completion, and the Department's competency-evaluation duty. Regulatory authority: M.G.L. c. 111, sec. 72W.\", \"url\": \"https://www.mass.gov/regulations/105-CMR-15600-the-training-of-nurses-aides-in-long-term-care-facilities\"}, {\"label\": \"Massachusetts Nurse Aide Candidate Handbook, D&S Diversified Technologies LLP / Headmaster LLP, May 2026 edition, Version 7.0 - linked by the Department from its become-a-CNA and training-program pages as 'the Nurse Aide Candidate Handbook available on the Massachusetts Nurse Aide page of the D&S website'. Establishes the DPH approval of the testing contractor; the definition and purpose of the Massachusetts Nurse Aide Registry; 'you must renew it every 24 months ... at least eight (8) consecutive hours during the previous 24 months'; the out-of-state reciprocity conditions and the training-waiver pointer; the fee table ($30 knowledge, $70 skill, $100 both, $10 audio surcharge, $35 refund processing fee, $25 test review deposit); the 60-question, 60-minute knowledge exam and its twelve-subject blueprint; the three-or-four-task, 40-minute skill exam with handwashing required at the end of each mandatory task; the attempt limits and the retraining consequence; the alternate-language switching rules; and the test-day identification, attire and no-show policies.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Massachusetts/forms/MA%20Candidate%20Handbook%205.2026.pdf\"}, {\"label\": \"Mass. Gen. Laws ch. 111, sec. 72J, Massachusetts General Court. The registry statute - the Department's duty to establish and maintain the registry, the hiring prohibition for facilities other than rest homes, the contents of the registry including findings against nurse aides, home health aides and homemakers and the individual's disputing statement, the duty on all facilities, home health agencies and homemaker agencies to contact the registry before hiring, the notice-and-hearing requirement, the factors-beyond-control limit on neglect findings, and the Department's suspension power.\", \"url\": \"https://malegislature.gov/Laws/GeneralLaws/PartI/TitleXVI/Chapter111/Section72J\"}, {\"label\": \"Massachusetts DPH - Nurse Aide Registry Laws and Regulations. The Department's own list of the governing law: 105 CMR 155.00 and 105 CMR 156.00 on the state side, and 42 CFR 483.12, 483.35, 483.95, 483.150, 483.151, 483.152, 483.154, 483.156 and 483.158 on the federal side.\", \"url\": \"https://www.mass.gov/lists/nurse-aide-registry-laws-and-regulations\"}, {\"label\": \"D&S Diversified Technologies / Headmaster - Massachusetts Nurse Aide page, the vendor page the Department links by name. The index of Massachusetts-specific materials the Department routes candidates to: the candidate handbook, the reciprocity form, the training-waiver application, the knowledge, remotely proctored knowledge and skill test instructions (including translatable versions), the ADA accommodation form, the refund and test-review forms, the mock skills document, and the test-site agreement and equipment lists.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Massachusetts/MA_CNA_Home.htm\"}]",
   "page_url": "https://licensingatlas.com/cna/ma-cna/"
  },
  {
   "page_id": "md-cna",
   "state": "Maryland",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Maryland Board of Nursing (MBON), an agency of the Maryland Department of Health - Nursing Assistant Certification Program. Unlike the health-department registries several states run, Maryland's nurse aide credential is issued by the nursing board itself: regulation defines a 'Certificate' as 'a certificate issued by the Board to practice as a certified nursing assistant in the State' (COMAR 10.39.01.02B(4)), and the Board also approves every training program and every competency examination. The federally required nurse aide registry is folded into the same system rather than kept separately: 'The Board has a combined CNA certification database with the GNA registry,' and the Board publishes the abuse-finding list itself as the 'CNA-I (formerly GNA) Abuse Registry'. Applications, renewals and the public lookup all run through the Department's chart licensing system.",
   "board_url": "https://health.maryland.gov/mbon/Pages/nursing-assistant-certification.aspx",
   "application_url": "https://mdchart.health.maryland.gov/CHART/s/",
   "renewal_cycle": "Every two years, on a birthday-parity schedule that surprises people. 'Unless renewed for an additional two-year term ... a certificate expires in accordance with the following schedule: (a) The certificate of a certificate holder with an odd-numbered birth year expires on the 28th day of the certificate holder's birth month in an odd-numbered year; and (b) The certificate of a certificate holder with an even-numbered birth year expires on the 28th day of the certificate holder's birth month in an even-numbered year' (COMAR 10.39.01.10A(1)). A new certificate is protected at the front end: 'A certificate shall not expire within 180 calendar days of the date of issuance.' The work requirement is 16 hours, not 8. To renew, a certificate holder must provide 'satisfactory evidence, as required by the Board, of 16 hours of active employment, for compensation, as a nursing assistant within the 2-year period immediately preceding the date of expiration' (COMAR 10.39.01.10C(1)(d)); the statute says the same as 'Completion of 16 hours of active certified nursing assistant practice within the 2-year period immediately preceding the date of expiration' (Health Occ. 8-6A-08(c)(4)(i)). Maryland's figure is double the federal-style eight hours several states use. If the 16 hours are missing, the two classes diverge: 'If a CNA-I, take and pass a nursing assistant competency evaluation; or If a CNA-II, complete a nursing assistant training program' (COMAR 10.39.01.10C(2)). Notice and grace: 'At least 3 months before a certificate expires, the Board shall send the certificate holder a renewal notice' by first-class mail or electronic means, stating the expiration date, the date by which the renewal application must be received, the renewal fee, and - where a criminal history records check is due that cycle - notice and written instructions for completing it (10.39.01.10B). The Board is blunt that the notice is a courtesy, not a condition: 'Failure of a certificate holder to receive the renewal notice sent by the Board does not relieve the certificate holder of the responsibility to renew a certificate before it expires.' There is then a real cushion: 'A certificate holder has a 30 calendar day grace period beyond the expiration date of the certificate to renew the certificate' (10.39.01.10E), which the statute frames as a Board-granted 30-day extension (Health Occ. 8-6A-08(g)). A recurring background check is scheduled by birth month across a twelve-year rotation - 2025 covers August and September birth months, 2026 covers September and October, and so on through 2036 (COMAR 10.39.01.10D). No continuing education is part of any of this for a CNA - see the continuing-education details on this page.",
   "ce_hours": "No continuing education is required to renew a Maryland CNA-I or CNA-II certificate. The renewal conditions in COMAR 10.39.01.10C are entitlement, a complete application, the $40 fee, 16 hours of paid active practice in the preceding two years (or the retest/retrain alternative), and a criminal history records check when the birth-month rotation calls for one. The statute's renewal subsection for certified nursing assistants, Health Occ. 8-6A-08(c), contains no education element either. Sources checked: COMAR 10.39.01 in full, COMAR 10.39.02 in full, Health Occ. 8-6A-05 and 8-6A-08, the Board's Nursing Assistant Certification pages and the Board's CNA Bill implementation FAQ. The contrast inside Maryland's own statute is the point: the legislature plainly knew how to attach continuing education and attached it to the neighbouring credentials, not to this one. A certified medicine aide must 'Successfully complete a Board-approved medicine aide continuing education program' plus 100 hours of practice (8-6A-08(d)); a dialysis technician must complete '3 hours of continuing education approved by the Board' on top of 16 hours of practice and an active national certification (8-6A-08(e)); a medication technician must complete 'a Board-approved clinical refresher course' every two years plus 100 hours of practice (8-6A-08(f)). A CNA owes 16 hours of work and nothing else. What an employer owes is a different matter, and Maryland puts it in the Nurse Practice Act rather than in a renewal rule: 'Any additional clinical practice skills specific to a setting of practice shall be taught in that setting as a part of the employment training process in that setting' (Health Occ. 8-6A-14(d)). The federal 12-hours-a-year in-service duty on nursing facilities operates on the facility under 42 CFR Part 483 and is not a Maryland renewal condition.",
   "exam": "A written (or oral) test plus a clinical skills demonstration - the federally required nurse aide competency evaluation, called the nursing assistant competency evaluation in Maryland since April 1, 2026 and the GNA-CE before that. Who may sit it: 'An individual is eligible to sit for a nursing assistant competency evaluation if the individual: (1) Meets the education requirements set forth in Regulation .05A(1) of this chapter; or (2) Must retake a nursing assistant competency evaluation in order to renew or reinstate a certification' (COMAR 10.39.01.07A). Since April 1, 2026 there is no way around it: 'After April 1, 2026, all applicants for CNA certification must take the nursing assistant competency evaluation,' including nursing students who have already had a portion of their nursing programme accepted as equivalent training. Attempts - four in total, with a 45-DAY wait: 'An individual who fails to obtain a passing score on the first examination may retake a nursing assistant competency evaluation three additional times'; 'An individual shall wait at least 45 calendar days from the date of the prior evaluation before retaking'; and 'An individual who fails to obtain a passing score after taking a nursing assistant competency evaluation four times must complete a new approved nursing assistant training program or approved acute care nursing assistant training program before retaking' (COMAR 10.39.01.07D). The 24-MONTH window: an individual must sit the evaluation within 24 months of meeting the educational requirements, and missing that means retaking the training programme (10.39.01.07B-C). Service members are excepted from that window. What is on it: the Board points candidates to the vendor's Maryland candidate handbook, which it describes as explaining 'the written and clinical testing process, including the 20 skills tested in Maryland'. No question count, time limit or passing score for the state competency evaluation is published in any Maryland source we checked - regulation, the Board's pages and the Board's implementation FAQ were all checked. The 75 percent figure that does appear in Maryland's rules is the pass mark for the training program's own written final examination (COMAR 10.39.02.07B(3)), which is a different test.",
   "fees": "Maryland's CNA fees are set by regulation and are small. COMAR 10.39.01.03A: 'Initial certification fee - $20; Endorsement fee - $20; Renewal fee - $40; Verification of certification to another jurisdiction - $25; Returned check fee - $25; Duplicate certificate fee - $10.' Subsection B is one line: 'Fees are not refundable.' The Board's page states the renewal figure the same way: 'CNA certification is for a 2-year period following the date of the first renewal. Costs for renewal is $40 for the 2-year period.' Nothing is charged for the registry or for the add-on certifications: 'There is no cost for the registry', and 'There is no cost for GNA certification or renewal if the individual meets the requirements for GNA certification' - a statement written before the April 2026 merger, when GNA was still a separate designation. Costs Maryland does not set and does not collect: (1) the criminal history records check - the applicant submits 'All fees required by the Central Repository and the FBI' (COMAR 10.39.01.04A(3)(b)), and those are paid to the fingerprinting service and the FBI, not to the Board; (2) the competency evaluation, which is paid to the Board-approved testing vendor; (3) tuition for the training program; and (4) for foreign-educated nursing graduates, the transcript evaluation by the Board-approved vendor the Board's application form names as TruMerit. No figure for any of those four is published on the Board pages or in the regulations we checked, and none is asserted here. One penalty worth knowing: a certificate holder must notify the Board of a name or address change within 60 days, and 'If the certificate holder fails to notify the Board within the time required ... the Board may impose an administrative penalty of $25' (Health Occ. 8-6A-08(j)).",
   "legal_basis": "[{\"citation\": \"Md. Code Ann., Health Occupations, Title 8, Subtitle 6A (Certification of Nursing Assistants, Medication Technicians, and Dialysis Technicians), as amended by Chapters of 2024 (House Bill 1125 / Senate Bill 999) and Chapter 416 of 2025, effective April 1, 2026\", \"what_it_governs\": \"The whole Maryland nurse aide scheme: definitions including certified nursing assistant, certified medicine aide, geriatric nursing assistant and the approved training programs; the Board's duty to adopt regulations establishing qualifications; the minimum age of 16 and the good-moral-character requirement; the criminal history records check requirement; the two-year renewal term keyed to the birth month, the 16 hours of active practice, the alternatives when those hours are missing, the 30-day extension, reinstatement, the 60-day duty to report a name or address change and the $25 administrative penalty for failing to; and the employer duty that setting-specific clinical skills 'shall be taught in that setting as a part of the employment training process in that setting' (8-6A-14(d)).\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho&section=8-6A-05&enactments=false\"}, {\"citation\": \"Md. Code Ann., Health Occupations, 8-6A-08 (Renewal of certificate)\", \"what_it_governs\": \"Expiration on the 28th day of the birth month; the three-month renewal notice and what it must state; the renewal conditions for a certified nursing assistant including 16 hours of active practice and the training-program-or-competency-evaluation alternative; the separate and heavier renewal conditions for certified medicine aides (100 hours plus a Board-approved continuing education program), dialysis technicians (16 hours plus 3 hours of continuing education plus active national certification) and medication technicians (100 hours plus a clinical refresher course); the 30-day extension; reinstatement; the name-and-address notification duty and its $25 penalty; and the criminal history records check regime for selected renewal applicants.\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho&section=8-6A-08&enactments=false\"}, {\"citation\": \"COMAR 10.39.01 (Certification of Nursing Assistants), Maryland Board of Nursing, as amended at 53:11 Md. R.\", \"what_it_governs\": \"The exceptions to the certification requirement; the definitions of CNA, CNA-I, CNA-II, nursing assistant competency evaluation, nursing assistant training program, acute care nursing assistant training program, criminal history records check, good standing and temporary nurse aide; the fee schedule; general application provisions including the two sets of fingerprints and the 12-month abandonment rule; qualifications for initial certification and for endorsement; application contents and the training program's verification duty; eligibility for the competency evaluation, its 24-month window and its four-attempt limit with a 45-day wait; the 90-day temporary practice certificate; issuance only after the criminal history record information is reviewed; expiration on the birth-month parity schedule, the 16-hour renewal requirement, the birth-month CHRC rotation through 2036 and the 30-day grace period; and administrative reinstatement.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.02.aspx\"}, {\"citation\": \"COMAR 10.39.02 (Nursing Assistant Training Programs), Maryland Board of Nursing, as amended and recodified at 53:11 Md. R.\", \"what_it_governs\": \"Approval and ongoing responsibilities of training programs; administration, faculty, facilities and resources; the curriculum - the 100-hour minimum split 60 didactic and classroom-laboratory (including at least 16 hours of in-person laboratory in the pre-clinical curriculum) and 40 supervised clinical (including at least 16 hours in long-term care or caring for the elderly or chronically ill under direct supervision); the federal content requirement of 42 CFR 483.152(b) and the additional acute care skills list; the bar on client contact before the pre-clinical curriculum is taught; evaluation, including the 75 percent pass mark on the program's written final examination, the certificate of completion and the duty to give graduates registration information for a competency evaluation; renewal and withdrawal of program approval; voluntary closure; and the requirements for hybrid nursing assistant training programs.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.02.06.aspx\"}, {\"citation\": \"42 C.F.R. 483.151-483.154 and 42 C.F.R. 483.35(d), cited by Maryland as the federal frame\", \"what_it_governs\": \"The federal requirements Maryland's definitions point to. Regulation requires the curriculum to include 'the subject matters and skills listed in 42 CFR 483.152(b)', defines the competency evaluation as one that 'Meets the requirements under federal law', and imports the four-month allowance directly - the chapter does not apply to an individual who 'Practices as a certified nursing assistant-I for less than 4 months in accordance with 42 CFR 483.35(d)'. The Board summarises the federal rule as prohibiting nursing facilities from using individuals as nurse aides who have not completed a state-approved training and competency evaluation program. The federal text itself was not read as of August 16, 2026; nothing here is quoted from it, and the federal 75-hour floor is mentioned only as context for Maryland's higher 100.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Credentia, administering the NNAAP Nurse Aide Examination, with Headmaster approved as an additional vendor. The Board states both, in its own words: 'The nursing assistant competency evaluation is the examination approved by the Board that meets the requirements under federal law. The current Board-approved examination is the NNAAP Nurse Aide Examination offered by Credentia,' and 'Federal law permits the Board to approve more than one nursing assistant competency evaluation, so long as the examination meets the requirements under federal law. Due to current shortages in available testing dates for the NNAAP, at its October 23, 2024, meeting, the Board approved Headmaster as an additional vendor to administer a competency examination that meets federal requirements. The Board's goal is to increase testing capacity in Maryland to meet the demand for new CNA-I (or current CNA/GNA).' The name changed with the credential. The Board answers the question directly: 'Is the \"nursing assistant competency evaluation\" referred to in the CNA Bill the same as what is currently called the GNA-CE? Yes.' Older Maryland material calls the same test the GNA examination or GNA-CE and routes candidates through 'the Maryland Geriatric Nursing Assistant Testing Service' (MDGNATS), which the Board's page describes as 'offered by the Credentia' with a Maryland-specific candidate handbook 'which explains the written and clinical testing process, including the 20 skills tested in Maryland'. The Board keeps the results loop for itself rather than the vendor: 'Credentia notifies the Board of examination results', and 'The Board of Nursing is responsible for processing GNA certification and renewals, not the testing service.' Regulation defines the instrument without naming a vendor, which is why the vendor can change without a rule change: 'Nursing assistant competency evaluation means an examination approved by the Board that: (a) Determines the competency of the individual to practice as a CNA-I; and (b) Meets the requirements under federal law' (COMAR 10.39.01.02B(11)).",
   "training_hours": "100 hours minimum - 60 hours of didactic instruction and classroom laboratory training, and 40 hours of supervised clinical training - with two nested sub-minimums that most summaries drop. The rule: a training program 'shall provide a minimum of 100 hours of instruction. (2) Of the 100 hours, a minimum of: (a) 60 hours shall be devoted to didactic instruction and classroom laboratory training, with at least 16 hours of in-person laboratory training in the pre-clinical curriculum listed in B(3) of this regulation; and (b) 40 hours shall be devoted to supervised clinical training in a clinical facility' (COMAR 10.39.02.06A). The long-term-care floor inside the clinical hours: 'A training program shall have at least 16 of the 40 hours of supervised clinical training in the provision of long-term care facility services or caring for the elderly or chronically ill of any age, which shall be performed under direct supervision' (10.39.02.06A(3)). That requirement survived the GNA merger and is why a CNA-I is qualified for nursing-home work. No client contact until the pre-clinical block is taught: the pre-clinical curriculum is 'Role of the CNA; Infection control; Safety and emergency procedures, including the Heimlich maneuver; Communication and interpersonal skills; Promoting clients' independence; and Legal and ethical considerations, including respecting clients' rights', and 'A training program shall provide instruction in the pre-clinical curriculum before a student has any direct contact with a client' (10.39.02.06B(3)-(4)). Content: the curriculum 'shall include the subject matters and skills listed in 42 CFR 483.152(b)'. An acute care nursing assistant training program covers that same federal list plus 'All basic skills required of a nursing assistant in any acute care practice setting', which the rule itemises down to transport of specimens and of medications, point-of-care testing, specimen collecting, equipment management, time management in the acute care setting, 'De-escalation of assertive or aggressive patients and family members', and 'Electronic documentation of care and basic computer skills' (10.39.02.06B(2)). Either program qualifies an applicant to sit the competency evaluation. Maryland's 100 is above the federal floor of 75 hours. A separate pass mark belongs to the program, not the state exam: to complete the program a student must 'Achieve a passing score of at least 75 percent on the written final examination' set by the program, complete the required minimum hours, demonstrate the ability to perform nursing functions with clients of any age and varying ability, and 'Demonstrate competence in meeting the objectives and performance indicators during didactic, laboratory, and clinical instruction' (10.39.02.07B). The program then gives the graduate 'A certificate of completion using the form required by the Board' and 'Registration information for a nursing assistant competency evaluation' (10.39.02.07C).",
   "lapse_rule": "A Maryland certificate lapses by failing to renew or by failing the 16-hour work test, and Maryland's way back is administrative rather than punitive. The grace period comes first: 'A certificate holder has a 30 calendar day grace period beyond the expiration date of the certificate to renew the certificate' (COMAR 10.39.01.10E). After that, reinstatement is a duty on the Board, not a discretion: 'The Board shall reinstate the certificate of a certificate holder who has failed to renew the certificate for any reason, if the certificate holder meets the renewal requirements in Health Occupations Article, 8-6A-08 ... and Regulation .10 of this chapter' (COMAR 10.39.01.11A). The statute is worded the same way (8-6A-08(h)). There is no published time limit after which reinstatement becomes impossible, and no reinstatement fee appears in the fee regulation - the $40 renewal fee is the only figure in the chapter that fits. One extra step after a year: 'An applicant for administrative reinstatement who has failed to renew the certificate for a period of 1 year or more shall submit to a CHRC before the certificate is reinstated' (10.39.01.11B). If the problem is the 16 hours rather than the paperwork, the fix depends on which class you hold: a CNA-I must 'take and pass a nursing assistant competency evaluation'; a CNA-II must 'complete a nursing assistant training program' (10.39.01.10C(2)). A CNA-I retaking the evaluation for this reason is expressly made eligible to sit it (10.39.01.07A(2)). An abuse finding is a different and heavier thing. Maryland's combined certification database carries the federally required registry, and the Board publishes a standing document listing certificate holders with findings - the 'CNA-I (formerly GNA) Abuse Registry', naming the offence as resident abuse, resident neglect, misappropriation of resident property, resident theft or abuse of a vulnerable adult, with the date of finding. Entries in the copy read for this page run from 1999 to 2026, which is consistent with findings that do not age off. An applicant may not have 'A record of abuse, negligence, or misappropriation of a client's property or any disciplinary action taken or pending in any other state or territory' (COMAR 10.39.01.05C(2)), so a finding blocks certification in the first place as well as ending it. No petition or removal procedure for such a finding appears in COMAR 10.39.01.",
   "reciprocity": "Maryland calls it endorsement, charges $20 for it, and applies a substantive equivalence test rather than a courtesy transfer. The test: an applicant shall '(1) Hold a certificate to practice as a nursing assistant that: (a) Was issued by another state or territory of the United States that has certification requirements that are essentially similar to those set forth in Health Occupations Article, 8-6A-05, Annotated Code of Maryland; and (b) Is in good standing; and (2) Have successfully completed a nursing assistant training program that meets the standards for an approved nursing assistant training program set by the Board' (COMAR 10.39.01.05B). Both limbs matter: an out-of-state certificate on its own is not enough if the training behind it does not meet Maryland's standards. 'Good standing' means 'without an encumbrance that limits or restricts practice, such as revocation, suspension, or probation' (10.39.01.02B(10)). How it is filed: the applicant complies with the general application requirements including the criminal history records check, pays the $20 endorsement fee, and arranges for two verifications to be sent 'directly to the Board from the appropriate authority' - the out-of-state certificate in good standing, and 'A certificate of completion from a nursing assistant training program in that state or territory that meets the standards for an approved nursing assistant training program set by the Board' (10.39.01.06B). The same disqualification test applies: no act or omission that would be grounds for discipline, and no record of abuse, negligence or misappropriation or pending discipline anywhere in the United States (10.39.01.05C). Going the other way, Maryland charges '$25' for 'Verification of certification to another jurisdiction' (10.39.01.03A(4)). Two things this page does not claim, because no Maryland source we checked states them: a processing time for an endorsement application, and whether an endorsement applicant is exempted from the competency evaluation. Regulation lists the competency evaluation under initial certification (10.39.01.05A) and does not repeat it in the endorsement subsection, but the Board's post-April-2026 statement that 'all applicants for CNA certification must take the nursing assistant competency evaluation' is written without an endorsement carve-out. An endorsement applicant should ask the Board which reading governs.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Maryland Board of Nursing - Nursing Assistant Certification (the Board's current CNA landing page, marked updated 9/3/2026). Establishes the Board's June 22, 2026 status notice that its chart system 'is now able to process CNA-I AND CNA-II electronic transactions'; the verification instruction ('A nursing assistant can be verified using name, certification number or partial social security number'); the primary-source-verification statement and the warning that paper certificates are easy to forge; the links to the Board's approved training programs, to the Credentia exam testing service and to the Register/Login application portal; and the Board's e-mail routing for initial certification, renewal, endorsement, medication technician certification and renewal, initial dialysis technician certification and dialysis technician renewal, and training-program questions for both nursing assistants and dialysis technicians.\", \"url\": \"https://health.maryland.gov/mbon/Pages/nursing-assistant-certification.aspx\"}, {\"label\": \"Maryland Board of Nursing - Frequently Asked Questions: HB1125/SB0999, 2024 Legislative Session, The CNA Bill (Board document, last updated March 18, 2026). The single most important Maryland source for anything published after April 2026. Establishes the signing date of May 16, 2024 and the effective date of April 1, 2026; 'The CNA Bill creates two types of CNA: CNA-I and CNA-II'; the abolition of the GNA, School Health, Home Health and Developmental Disabilities categories; the practice-setting difference between CNA-I and CNA-II; the two-step CNA-I requirement; that the nursing assistant competency evaluation is the former GNA-CE and 'The current Board-approved examination is the NNAAP Nurse Aide Examination offered by Credentia', with Headmaster approved as an additional vendor at the Board's October 23, 2024 meeting; the automatic certificate re-titling with unchanged certificate numbers; the CNA-II to CNA-I upgrade path; the 16-hour renewal requirement and its two alternatives; the deadline for CNA-only training programs to re-submit for approval; the definition of an acute care nursing assistant training program; the nursing-student exceptions; and the employer's setting-specific training duty under Health Occ. 8-6A-14(d).\", \"url\": \"https://health.maryland.gov/mbon/Documents/new-cna-faqs-final.pdf\"}, {\"label\": \"Maryland Board of Nursing - Nursing Assistant Certification information page (marked updated 1/30/2024). The Board's older CNA overview, still live. Establishes 'All nursing assistants must be certified in order to work'; the pre-2026 structure in which 'The CNA certification is the basic level of certification' with GNA, CMA and Dialysis Technician as additional certifications appearing on the CNA card; the CMA prerequisite of one year of experience plus 'an approved 60-hour medicine aide course taught in a community college'; the combined CNA certification database and GNA registry and 'There is no cost for the registry'; that examinations 'are offered through Credentia Nurse Aide Credentialing Services and the Maryland Geriatric Nursing Assistant Testing Service' and that 'Credentia notifies the Board of examination results'; the Maryland candidate handbook 'which explains the written and clinical testing process, including the 20 skills tested in Maryland'; the requirement that training programs be Board-approved before accepting students; 'CNA certification is for a 2-year period ... Costs for renewal is $40 for the 2-year period'; and the odd-year/even-year birth-month expiration rule.\", \"url\": \"https://health.maryland.gov/mbon/Pages/cna-info.aspx\"}, {\"label\": \"COMAR 10.39.01.02 (Definitions), Code of Maryland Regulations, published by the Maryland Division of State Documents. The source of the CNA, CNA-I, CNA-II, criminal history records check, good standing, nursing assistant competency evaluation, nursing assistant training program, acute care nursing assistant training program, temporary nurse aide and temporary nurse aide training definitions, each carrying the Maryland Register citation 53:11 Md. R. 26-016-F.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.02.aspx\"}, {\"label\": \"COMAR 10.39.01.03 (Fees). The complete fee schedule: 'Initial certification fee - $20; Endorsement fee - $20; Renewal fee - $40; Verification of certification to another jurisdiction - $25; Returned check fee - $25; Duplicate certificate fee - $10', and 'Fees are not refundable.'\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.03.aspx\"}, {\"label\": \"COMAR 10.39.01.05 (Qualifications for Certification). The four education routes plus the competency evaluation; the endorsement test of 'essentially similar' out-of-state requirements plus a training program meeting Board standards; the disqualification test covering discipline and any record of abuse, negligence or misappropriation anywhere in the United States; the content list a portion of a nursing education program must cover; the CNA-II to CNA-I rule; and the temporary nurse aide deeming provision with its 100 hours of on-the-job training and 160 hours of competent work.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.05.aspx\"}, {\"label\": \"COMAR 10.39.01.07 (Nursing Assistant Competency Evaluation). Eligibility to sit; the 24-month window and the consequence of missing it; and the retesting rule - three retakes after a first failure, at least 45 calendar days between attempts, and a new approved training program after four failures.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.07.aspx\"}, {\"label\": \"COMAR 10.39.01.10 (Expiration and Renewal). The odd-year/even-year birth-month expiration schedule and the 180-day protection for a new certificate; the three-month renewal notice and its required contents; the renewal conditions including '16 hours of active employment, for compensation, as a nursing assistant within the 2-year period immediately preceding the date of expiration'; the CNA-I retest / CNA-II retrain alternatives; the birth-month criminal history records check rotation from 2025 through 2036; and the 30 calendar day grace period.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.01.10.aspx\"}, {\"label\": \"COMAR 10.39.02.06 (Curriculum). The hour rule in full: 'a minimum of 100 hours of instruction', of which at least '60 hours shall be devoted to didactic instruction and classroom laboratory training, with at least 16 hours of in-person laboratory training in the pre-clinical curriculum' and '40 hours shall be devoted to supervised clinical training in a clinical facility', with 'at least 16 of the 40 hours of supervised clinical training in the provision of long-term care facility services or caring for the elderly or chronically ill of any age'; the 42 CFR 483.152(b) content requirement; the acute care skills list; the six pre-clinical topics; and the bar on client contact before the pre-clinical curriculum is taught.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.02.06.aspx\"}, {\"label\": \"COMAR 10.39.02.07 (Evaluation). What a student must do to complete a program: the required minimum hours, demonstrated ability with clients of any age and varying ability, 'a passing score of at least 75 percent on the written final examination', and demonstrated competence against the objectives and performance indicators - plus the program's duty to issue a Board-form certificate of completion, provide registration information for a competency evaluation, and submit written verification of completion to the Board within 5 business days.\", \"url\": \"https://dsd.maryland.gov/regulations/Pages/10.39.02.07.aspx\"}, {\"label\": \"Maryland Board of Nursing - Initial Application for CNA-I Certification, Nursing Assistant Certification Program (the Board's current paper form, published under a filename dated 20260401). Establishes the three education routes as they appear on the form, the 24-month recency question, the transcript routes for United States and foreign-educated nursing graduates (naming TruMerit as the Board-approved foreign transcript evaluator), the four background questions and the documentation each triggers including two character reference letters, the 2 inch by 2 inch photograph requirement, and the Training Program Certification block certifying completion 'in accordance with COMAR 10.39.02.07B'.\", \"url\": \"https://health.maryland.gov/mbon/Documents/certified-nursing-assistant-1-initial-application-20260401.pdf\"}, {\"label\": \"Maryland Board of Nursing - CNA-I (formerly GNA) Abuse Registry, updated July 15, 2026. The Board's published list of certificate holders with substantiated findings, showing last name, first name and middle initial, certificate number, date of birth, date of finding and offence (resident abuse, resident neglect, misappropriation of resident property, resident theft, abuse of a vulnerable adult). Its title is itself evidence that CNA-I has replaced GNA as the operative term.\", \"url\": \"https://health.maryland.gov/mbon/Documents/cna-i-abuse-registry.pdf\"}, {\"label\": \"Maryland Board of Nursing - Certification Training Programs (marked updated 4/6/2026). The Board's page for approved programs, listing 'Approved CNA Programs (effective 4/1/2026)' alongside the Nursing Assistant Training Program Application, the Acute Care Nursing Assistant Training Program Application, the certificates of completion for each, the Maryland skills list, the laboratory equipment and supply list, and the voluntary closure, substantial change, faculty change, clinical facility profile and annual report forms.\", \"url\": \"https://health.maryland.gov/mbon/Pages/nursing-assistant-training-programs.aspx\"}, {\"label\": \"Md. Code Ann., Health Occupations, 8-6A-05 (Qualifications; application), Maryland General Assembly statute text. Displays two versions side by side - one labelled 'IN EFFECT' carrying the pre-2026 category structure including geriatric nursing assistants, home health aides and school health aides, and one labelled 'TAKES EFFECT APRIL 1, 2026 PER CHAPTER 416 OF 2025' carrying the restructured text. The April 2026 version is the one the Board's regulations, forms and notices implement.\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho&section=8-6A-05&enactments=false\"}, {\"label\": \"Md. Code Ann., Health Occupations, 8-6A-08 (Renewals), Maryland General Assembly statute text. The source of the 16 hours of active certified nursing assistant practice, the three-month renewal notice, the 30-day extension, reinstatement, the 60-day name-and-address notification duty with its $25 administrative penalty, and the sharply different renewal conditions for certified medicine aides, dialysis technicians and medication technicians.\", \"url\": \"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho&section=8-6A-08&enactments=false\"}]",
   "page_url": "https://licensingatlas.com/cna/md-cna/"
  },
  {
   "page_id": "me-cna",
   "state": "Maine",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Two agencies share this credential, and Maine says so on its own page. The Maine Department of Health and Human Services, Division of Licensing and Certification, operates the Maine Registry of Certified Nursing Assistants and Direct Care Workers - the statute directs that 'The Department of Health and Human Services shall maintain the registry and make it accessible through a public website portal' (22 M.R.S. 1812-G(1)) - and DHHS also approves the training programs (32 M.R.S. 2104(4)). The Maine State Board of Nursing writes the curriculum and the eligibility rules: 'The State Board of Nursing shall adopt rules ... defining eligibility requirements for listing on the registry as a certified nursing assistant' (22 M.R.S. 1812-G(3)), and the statutory definition of a certified nursing assistant turns on 'the eligibility requirements established by the State Board of Nursing for listing on the registry' (22 M.R.S. 1812-G(1-B)(B)). The public lookup sits on a third system, the state's Regulatory Licensing and Permitting service (ALMS), under the regulator name 'CNA AND DIRECT CARE REGISTRY'.",
   "board_url": "https://www.maine.gov/dhhs/dlc/cna-registry",
   "application_url": "https://www1.maine.gov/cgi-bin/online/licensing/begin.pl?board_number=6719",
   "renewal_cycle": "Every 24 months, and Maine requires three things at once rather than one. The Department: 'There are three requirements to stay active. (1) You must complete a minimum of at least 8 hours of qualified employment every 24 months; (2) You must have no disqualifying annotations; and (3) you must renew your CNA Registry listing every 24 months. Failure to meet any one of these requirements bars you from working as a CNA in Maine.' The eight hours are narrowly defined: 'Qualified employment is employment in a health care setting, under the supervision of a registered professional nurse, that can be applied to meet the minimum work requirement of 8 hours within 24 consecutive months that is needed to stay on the Registry. Failure to work the minimum hours will result in removal from the Registry.' The rule adds that the work must be paid and in the CNA capacity: 'the C.N.A. must submit documented proof of qualified employment for monetary compensation for a minimum of eight hours within the last 24 consecutive months under the supervision of a registered professional nurse in a health care setting, in the capacity of a C.N.A. on a full or part-time basis' (10-144 CMR ch. 128, sec. 2(A)(2)(b)). 'Health care settings include hospitals, nursing facilities, home health agencies, and assisted housing programs' (Department definitions); the state's CNA Employment Verification Form offers Hospital, Assisted Housing, Residential Care, Corrections, Home Health Agency, Hospice, Nursing Home and Ambulatory Surgical Center as the facility types, and asks whether the CNA was in a contracted position. Who signs: the employer, never the CNA. The verification form states that 'Authorized Personnel is the facility's management/HR staff not the CNA,' and the signature attests 'that the work requirements above have been met.' The reminder and the deadline: 'The Division of Licensing and Certification will send out a renewal form approximately 45 to 60 days prior to the expiration of a current CNA certificate,' returnable by mail or through the online portal. The rule is unforgiving about timing: 'To remain on the Registry, a C.N.A. must submit a completed renewal form and the required documents on or before their current expiration date,' and 'Failure to submit a timely completed renewal form and required documentation shall result in immediate removal from the Registry and bars future employment as a C.N.A. until the C.N.A. takes appropriate action pursuant to this rule to be reinstated' (10-144 CMR ch. 128, sec. 2(A)(3)(a)-(b)). Because the reminder is posted, 'Please make sure the Registry always has your current address.'",
   "ce_hours": "No continuing education is required of the CNA to renew. Maine renews on paid work plus a clean record plus a filed form; no course requirement appears in 10-144 CMR ch. 128, in 02-380 CMR ch. 5, in 22 M.R.S. 1812-G, or on any Department CNA page we checked. What exists is an employer duty in nursing facilities, and the Department answers the question in exactly those terms: 'Are there annual training requirements to stay active on the Registry? Nursing facilities must provide CNAs with no less than 12 hours per year of in-service education.' The rule repeats it and adds the paperwork: 'Nursing facilities must provide C.N.A.s with no less than 12 hours per year of in-service education (OBRA '87). Documentation of completed in-service education is given to the C.N.A.' (10-144 CMR ch. 128, sec. 2(B)(3)(c)). The Department tells CNAs to hang on to that documentation: 'Keep this information with your important papers. You will need it when you renew your listing on the Registry.' That is a duty on the facility rather than a condition the Registry itself tests at renewal - the three renewal conditions the Department publishes are the eight hours, no disqualifying annotations, and the filed renewal form. For CNA-Ms the maintenance obligation is different again and is set by the employer: 'A health care facility applying for Board approval to conduct the medication course shall provide a mechanism for maintaining competency' (02-380 CMR ch. 5, sec. 4(H)(1)), and the Department tells CNA-Ms to 'comply with the mechanism for maintaining competency provided by the health care facility that employs you.'",
   "exam": "Two parts, both required, and Maine defines it in one line: 'The Maine CNA competency test is a 2-part test including a written or oral examination, and a skills demonstration test' (Department, CNA Definitions). The rule's version, with the attempt limit: 'Each student must satisfactorily complete both parts of the competency evaluation test: 1. The student must pass a written or an oral examination; and 2. The student must demonstrate an ability to successfully complete skills listed on the MSBON curriculum checklist. 3. The student will be allowed no more than three attempts to pass the Maine C.N.A. test within 2 years from the completion date of training, in accordance with CFR title 42 483.154 (f)(2). If this criterion is not met, the C.N.A. training program must be retaken' (10-144 CMR ch. 128, sec. 2(B)(1)(a)(ii)). The oral option is written into the test itself rather than granted on request, and the skills half is judged against the Board's own checklist - 'All skills must be demonstrated, and the student must perform return demonstrations satisfactorily, either in the clinical setting or in the skills laboratory' (02-380 CMR ch. 5, sec. 2(A)(4)). The non-traditional test is a separate examination with its own attempt rule: 'If a non-traditional C.N.A. fails to pass the test on their first attempt, they will be allowed no more than two additional attempts to pass the test. If the C.N.A. does not pass the test within two years from the date of the first scheduled exam, the C.N.A. must complete and pass the full C.N.A. training program before being allowed to test again' (10-144 CMR ch. 128, sec. 2(B)(1)(c)(iii)). Who may take it: 'A C.N.A. trained in Maine who has not worked as a C.N.A. for at least 8 hours in the preceding 24 months; or an individual trained as a C.N.A., or its equivalent, while serving in the United States Armed Services who completed training that is at least equal to the Maine minimum of approved C.N.A. training required by these rules.' No passing score for the state competency test is published in any Maine source we checked. The 70 percent figure that does appear is the classroom pass mark inside the training program ('A minimum passing standard of 70% is required in the class portion of the program'), not the cut score of the competency test - the two are different things and Maine never equates them. One route skips the test entirely: a nursing student holding a Certificate of Equivalent Training may be listed and 'Further testing is not required if the Registry finds the individual is competent to function as a C.N.A.' (10-144 CMR ch. 128, sec. 2(A)(5)).",
   "fees": "Maine charges the CNA nothing, and it says so twice. The Department's FAQ: 'Do I have to pay to be listed on the Registry? No. Federal CNA law prohibits Maine from charging an applicant or a CNA a fee to be listed on the Registry.' The Department's own rule makes it a standing prohibition covering renewal too: 'No C.N.A. fee. The Department may not charge an applicant or a C.N.A. a fee related to the application and the biennial renewal for listing on the Maine Registry' (10-144 CMR ch. 128, sec. 2(A)(1)). The two-page Application for Listing on the CNA Registry has no fee line, no payment instruction and no cheque-payable-to field. The one fee in the statute is charged to employers and may not be passed on: 'The department may establish a provider verification fee not to exceed $25 annually per provider for verification of a certified nursing assistant's credentials and training. Providers may not pass the cost on to the individual certified nursing assistant' (22 M.R.S. 1812-G(4-A)). Those receipts fund the Registry, 'including but not limited to the cost of criminal history record checks.' Whether the Department has actually established that fee, and at what amount, is not stated on any Department page we checked - the statute is permissive. The background check is also not yours to pay: the training program 'must secure or pay for a background check on each individual who applies for enrollment' (22 M.R.S. 1812-G(6-A)(A)), and employers 'shall secure and pay for a background check prior to hiring' (6-A(B)). Tuition is set by each approved program and is not published by the state. Federal protections apply through Maine's own rule: an individual employed by or holding an offer from a nursing facility on or before the day training or the competency evaluation begins 'may not be charged for any portion of the program (including any fees for textbooks or other required course materials)', and a CNA hired within 12 months of finishing 'must be reimbursed by the nursing facility for the costs incurred' (10-144 CMR ch. 128, sec. 2(B)(3)(a)-(b)). No fee is published for the competency test, the non-traditional test, a duplicate certificate or a reciprocity form in any Maine source we checked.",
   "legal_basis": "[{\"citation\": \"22 M.R.S. 1812-G (Maine Registry of Certified Nursing Assistants and Direct Care Workers), as amended by PL 2023, c. 241, PL 2023, c. 309 and PL 2025, c. 305, Pt. C\", \"what_it_governs\": \"The Registry's existence and public web portal; the statutory definition of a certified nursing assistant; who must be listed; the three categories of registry notation; the Board of Nursing's authority to write the eligibility rules including temporary listing for out-of-jurisdiction training; the petition to remove a one-time substantiated finding of neglect or misappropriation; the permissive provider verification fee capped at $25 a year that may not be passed on to the CNA; employer verification duties; the prohibition on employing anyone with a disqualifying offence; the background-check regime including the training program's duty to secure or pay for it; the table of crimes with 5-, 10- and 30-year employment bans; complaint investigation, written decision and appeal; and the lifetime employment ban that follows a substantiated finding.\", \"url\": \"https://legislature.maine.gov/statutes/22/title22sec1812-G.html\"}, {\"citation\": \"32 M.R.S. 2104(4) (Approval and monitoring of nursing assistant training curriculum and faculty), as amended by PL 2021, c. 81\", \"what_it_governs\": \"The split of duties between the two agencies: an educational institution or health care facility wanting to run a nursing assistant program 'must apply to the Department of Health and Human Services' and show it can carry out 'the curriculum for nursing assistants as prescribed by the board', meet the Board's standards, and meet the Department's standards for educational programming and faculty - after which 'The Department of Health and Human Services shall issue a notice of approval'.\", \"url\": \"https://legislature.maine.gov/statutes/32/title32sec2104.html\"}, {\"citation\": \"02-380 C.M.R. ch. 5 (Board of Nursing - Regulations Relating to Training Programs and Delegation by Registered Professional Nurses of Selected Nursing Tasks to Certified Nursing Assistants)\", \"what_it_governs\": \"Delegation and supervision of CNAs by registered professional nurses, including the home-care medication carve-out and the additional-skills list; the prescribed generalist curriculum and its 70/20/40 hour minimum; instructor qualifications and the one-to-ten clinical ratio; student admission qualifications (ninth grade, age 16, ninth-grade English reading and writing competency); the contents of the certificate of training and the nursing-school certificate of equivalent training; acceptance of CNAs educationally prepared outside Maine; the Standardized Medication Course for Certified Nursing Assistants and its separate 60/20/40 hours; the eligibility routes for entry on the Registry; the four-month non-renewable temporary listing; and ineligibility for fraud or deceit in obtaining a certificate of training. The Board publishes this file as the adopted rule revised 7/24/25, while the document's own closing line reads 'EFFECTIVE: January 1, 2023'.\", \"url\": \"https://www.maine.gov/boardofnursing/sites/boardofnursing/files/archive/Chapter_5_Adopted_Rule_rev.7.24.25.pdf\"}, {\"citation\": \"10-144 C.M.R. ch. 128 (Certified Nursing Assistant and Direct Care Worker Registry Rule), effective June 15, 2019\", \"what_it_governs\": \"The Department's operation of the Registry: the prohibition on charging a CNA any fee for application or biennial renewal; the recording of the competency-test completion date; the eight-hours-in-24-months work requirement and the immediate removal that follows a failure to report it; the 24-month renewal term and immediate removal for a late renewal; the nursing-student listing without further testing; the three training and testing options including the non-traditional examination and its attempt limits; the three-attempts-within-two-years limit on the Maine test; document lists for Maine-trained, out-of-jurisdiction and all applicants; the training program's background-check duty; the federal no-charge and reimbursement rules and the 12 hours of annual in-service education; what the Registry must disclose to any requester; Registry content; and the complaint, petition and appeal procedures.\", \"url\": \"https://www.maine.gov/sos/sites/maine.gov.sos/files/content/assets/144c128.docx\"}, {\"citation\": \"Prescribed Generalist Curriculum of Nursing Assistant Training Programs, approved by the Maine State Board of Nursing June 5, 2019 (published by the Board as the 9-6-2021 New CNA Curriculum)\", \"what_it_governs\": \"The curriculum itself and the hour table that totals it - 'Theory 70 hours; Skills Laboratory 20 hours; Clinical 40 hours; Total 130 hours' - plus the rule that the certificate of training is issued by the educational program on successful completion of the program and competency testing, the three-year record-retention duty on programs, the 70 percent classroom pass mark, the pass/fail recommendation for skills, the one-to-ten clinical ratio, and Appendix B, the Official CNA Skills List that bounds what a CNA may ever do.\", \"url\": \"https://www.maine.gov/boardofnursing/sites/boardofnursing/files/2026-06/9-6-2021-%20New%20CNA%20Curriculum.pdf\"}, {\"citation\": \"42 C.F.R. 483.150-483.158 and 42 C.F.R. 488.301, cited by Maine as the federal frame\", \"what_it_governs\": \"The federal requirements Maine's registry is built on. The Department states that 'The Registry is operated in accordance with 42 CFR 483.156, Registry of nurse aides; 42 CFR 483.152, Requirements for approval of a nurse aide training and competency evaluation program', defines abuse for registry purposes by reference to 42 C.F.R. 488.301, and ties the three-attempts rule to 42 C.F.R. 483.154(f)(2). The federal text itself was not read as of August 16, 2026; nothing on this page is quoted from it, and the federal 75-hour floor is mentioned only as context for Maine's higher 130.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Maine names no national testing vendor - and that is the finding, not a gap. Across the Department's CNA Registry page, its Frequently Asked Questions, its CNA Definitions page, the Board of Nursing's Chapter 5 rule, the Board's Prescribed Generalist Curriculum and the Department's registry rule 10-144 CMR ch. 128, no state source we checked names Credentia, the NNAAP, Prometric, Headmaster or any other examination contractor for Maine-trained candidates. All six were checked. What Maine publishes instead is a test delivered through the approved training program itself. The Board's curriculum states the sequence in one sentence: 'Upon successful completion of the program and competency testing, the nursing assistant will be issued a standardized certificate of training by the educational program, who will maintain records of student training and certificates for a minimum of 3 years.' The Department's definition of the Certificate of Training says the same - it is 'a document issued by the CNA training program to an individual who has satisfactorily completed an approved training program and competency test.' Skills are judged by the program's registered nurse instructor: 'Students are evaluated through direct observation by the instructor, who determines how many attempts the student should have for each skills item' (Board curriculum). A third-party testing company appears in only one place, and it is about other states: an applicant trained elsewhere must send 'A copy of the official score report from the testing company that conducted the competency evaluation, indicating a passing score in both theory and clinical competence' (10-144 CMR ch. 128, sec. 2(C)(3)(a)(i)). Separately, the Registry decides who may sit the non-traditional examination - among its listed duties is to 'Determine C.N.A.'s eligibility to take the C.N.A. Competency Evaluation test for non-traditional nursing assistants' (10-144 CMR ch. 128, sec. 2(E)(2)) - but no source read states who administers that test either. Because aggregator charts disagree with each other on Maine's vendor, and no state source settles it, this page names none.",
   "training_hours": "130 hours - 70 hours of classroom theory, 20 hours of skills laboratory and 40 hours of supervised clinical practice - and all three Maine sources agree exactly. The Board rule states it as a floor without adding it up: 'No program shall be conducted that includes less than 70 hours of classroom instruction, 20 hours of skills laboratory and 40 hours of correlated, supervised clinical practice (Shall be effective September 1, 2021)' (02-380 CMR ch. 5, sec. 2(A)(2)). The Board's curriculum does the arithmetic: 'The minimum hours for the curriculum shall be: Theory 70 hours; Skills Laboratory 20 hours; Clinical 40 hours; Total 130 hours' (Prescribed Generalist Curriculum of Nursing Assistant Training Programs, approved by the Maine State Board of Nursing June 5, 2019). The Department states the total in reader language: 'Maines approved CNA training program is 130 hours of training including 70 hours of classroom theory, 20 hours of clinical laboratory work, and 40 hours of supervised clinical practice.' Maine's 130 is well above the federal floor of 75 hours. A number that looks like the answer and is not: 60 hours of classroom instruction, 20 hours of skills laboratory and 40 hours of supervised clinical practice - 120 hours - is the medication course for a CNA-M, not CNA training. The Board rule keeps them apart in two different sections: sec. 2(A)(2) (the 70/20/40 CNA program) and sec. 4(B)(4), 'No medication course shall be conducted that includes less than 60 hours of classroom instruction, 20 hours of skills laboratory and 40 hours of correlated, supervised clinical practice.' The Department's comparison chart of CNA-M against CRMA prints the 60/20/40 line without repeating that it belongs to the medication course, which is exactly how the wrong number gets copied. A classroom pass mark is also published: 'A minimum passing standard of 70% is required in the class portion of the program', with pass or fail recommended for the skills portion (Board curriculum). The rule states the same as a program duty: instructional staff shall set requirements for 'scholastic achievement; (minimum of 70%)' (02-380 CMR ch. 5, sec. 2(D)(2)(a)). Two structural rules attach to the clinical hours: 'The clinical instructor/student ratio must be at least one instructor for every ten students. The registered professional nurse instructor must provide direct onsite supervision during clinical learning experiences' (sec. 2(A)(3)), and only registered professional nurses may serve as classroom and clinical instructors (sec. 2(C)(2)). Programs may not teach beyond the prescribed curriculum (sec. 2(A)(6)).",
   "lapse_rule": "Two different failures end a Maine listing, and they have different ways back. (1) not working the eight hours. The removal is automatic and the return is a test: 'failure to notify the C.N.A. Registry of at least eight hours of employment as a C.N.A. during the 24-month period from the date of completion of the competency test shall result in the immediate removal of the C.N.A. from the list of active C.N.A.s. The individual may not be employed as a C.N.A. until they successfully complete the test for non-traditional C.N.A.s, the Department receives an application for placement on the Registry and the Registry determines the individual is eligible for placement' (10-144 CMR ch. 128, sec. 2(A)(2)(a)). The non-traditional test allows one attempt plus 'no more than two additional attempts', and if it is not passed 'within two years from the date of the first scheduled exam, the C.N.A. must complete and pass the full C.N.A. training program before being allowed to test again' (sec. 2(B)(1)(c)(iii)). (2) not renewing on time. 'Failure to submit a timely completed renewal form and required documentation shall result in immediate removal from the Registry and bars future employment as a C.N.A. until the C.N.A. takes appropriate action pursuant to this rule to be reinstated on the Registry' (sec. 2(A)(3)(b)). The state's online service carries a distinct 'Reinstate an inactive CNA Certificate' function alongside renewal, and the paper application has an 'Inactive - applying for reinstatement' checkbox; the Department also directs a 'CNA who has been inactive on the Maine registry for more than two years' to the full application rather than the renewal. A lapse is not an annotation. Annotations are the other, far heavier way to lose the credential, and they follow criminal convictions and substantiated findings rather than inactivity. Under the statute as amended in 2025, 'A certified nursing assistant, a registered direct care worker or an immediate supervisor with a notation of a substantiated finding on the registry is banned for life from employment as a certified nursing assistant, a direct care worker or an immediate supervisor' (22 M.R.S. 1812-G(13)), and disqualifying criminal convictions carry 'an employment ban of 5, 10 or 30 years' set by rule against a table of crimes (22 M.R.S. 1812-G(6-C)(A)(1)). A one-time substantiated finding of neglect or misappropriation of property may be petitioned out: 'No sooner than 12 months after the date a substantiated finding of neglect or misappropriation of property is placed on the registry, a direct care worker may petition the department to remove the notation from the registry if the substantiated finding is a one-time occurrence and there is no pattern' (22 M.R.S. 1812-G(3-B)). Where the Department's public page and the current statute diverge - recorded both ways, not resolved. The FAQ says 'Substantiated complaint annotations for abuse and misappropriation of property stay on your record permanently' and offers the petition only for neglect, whereas 22 M.R.S. 1812-G(3-B), as amended by PL 2025, c. 305, Pt. C, extends the petition to a one-time substantiated finding of neglect OR misappropriation of property. The FAQ also still publishes an exception for 'Convictions that occurred before June 1, 2003' for CNAs listed before that date, while the statutory subsection that carried that exception, 22 M.R.S. 1812-G(8), was repealed by PL 2023, c. 241, sec. 19. Anyone relying on either point should ask the Registry directly; this page states what each source says and attributes each.",
   "reciprocity": "Maine does not run a reciprocity application in the sense other states do - it runs an acceptance test for out-of-state training, plus a form for people leaving. Coming in, the Board's rule is the gate: an out-of-state nursing assistant may be listed if they have 'passed a nationally certified nursing assistant testing process that includes the evaluation of both theory and clinical competence' and either 'graduated from a certified nursing assistant program outside of the State of Maine within the last year' or 'been employed as a certified nursing assistant outside of the State of Maine for the last two years' (02-380 CMR ch. 5, sec. 3(A)). Anyone who fails that test 'must complete a Department of Health and Human Services approved certified nursing assistant training program' (sec. 3(B)). What you file: 'Complete the CNA application online or send us the completed PDF version. Include with your application a copy of your current photo ID and verification from all state(s) in which you currently hold or have held CNA certification. The name you provide on this application must match EXACTLY the name on your government-issued ID,' with the Department adding 'You must be current, active, and in good standing on at least one other State's CNA registry for placement.' Processing runs 'two to four weeks' on the registry page and up to 30 days in the FAQ and on the application form. There is no fee. While you wait, there are two four-month bridges: the temporary Registry listing for someone whose out-of-state training does not meet the acceptance test (02-380 CMR ch. 5, sec. 5(B)), and the nursing facility rule that lets a facility hire, for no more than four months, a CNA 'who ha[s] been granted reciprocity or has been deemed competent under Maine State Board of Nursing rules' (Department, quoting 10-144 CMR ch. 110). Neither may be renewed. Going out, Maine gives you a form and sends you to the other state: 'You must contact the CNA Registry in that state to find out what their requirements are for placement on their Registry ... A reciprocity form may be required. A reciprocity form confirms your status on the Maine CNA Registry and should facilitate your transfer to another state Registry.' A trap at the edge of reciprocity: training in another state that never produced a passed competency evaluation buys nothing here. Someone with 'no documentation to prove that I completed an out-of-state CNA training program' must complete Maine's approved training program and Maine's competency test before being considered. No processing fee, no examination requirement and no expiry for an accepted out-of-state listing is stated in any Maine source we checked.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Maine DHHS, Division of Licensing and Certification - CNA Registry. The Department's main nurse aide page. Establishes what the Registry is ('lists CNAs who, through training, competency testing, and clinical work experience, are authorized to work as CNAs in the state of Maine'), the legal frame it names (42 CFR 483.156 and 483.152, 22 MRS 1812-G, 32 MRS 2104, 10-144 CMR ch. 128 and 02-380 CMR ch. 5), 'You will need to successfully complete an approved 130-hour CNA training course before you can be placed on the CNA Registry', the out-of-state application instruction and the exact-name-match rule, 'Please allow two to four weeks for processing', 'A CNA certificate must be renewed every two years', the 45-to-60-day renewal notice, and the links to the application, the CNA Employment Verification Form, the Student Nurse Verification of Equivalent Training Form and the public look-up tool.\", \"url\": \"https://www.maine.gov/dhhs/dlc/cna-registry\"}, {\"label\": \"Maine DHHS - CNA Registry Frequently Asked Questions. Fifty-four numbered answers. Establishes 'If you are not listed as \\\"Active\\\" on the Registry, you cannot work as a CNA in Maine' and the four-month pre-listing hire allowance under 10-144 CMR ch. 110; 'No. Federal CNA law prohibits Maine from charging an applicant or a CNA a fee to be listed on the Registry'; the six document lists by applicant type; 'You must be at least 16 years old'; the ninth-grade rule; the 30-day eligibility determination; the three requirements to stay active; the 24-month renewal and its reminder; 'Maine's approved training program requires a minimum of 130 hours of training'; the skills-list limit on practice; the 12 hours of annual in-service education and the federal free-training and reimbursement rules; the annotation regime and the petition to remove a finding of neglect; the employment restrictions and their two exceptions; the substantiated-complaint and fraudulent-application procedures with their 30-day appeal windows; and the CNA-M requirements and the CNA-M versus CRMA comparison chart.\", \"url\": \"https://www.maine.gov/dhhs/dlc/cna-registry/frequently-asked-questions\"}, {\"label\": \"Maine DHHS - CNA Definitions. The Department's own glossary, and the source of several load-bearing sentences: 'A Certified Nursing Assistant (CNA) is a person listed on the CNA Registry who performs selected nursing services under the supervision of a registered professional nurse'; 'The Maine CNA competency test is a 2-part test including a written or oral examination, and a skills demonstration test'; 'Maines approved CNA training program is 130 hours of training including 70 hours of classroom theory, 20 hours of clinical laboratory work, and 40 hours of supervised clinical practice'; the Certificate of Training definition; the Official CNA Skills List and 'If a task is not on the official CNA skills list, the CNA may never perform that task'; qualified employment; health care settings; the criminal-conviction categories; and the definitions of CRMA, PSS, UAP, nursing school training and Verification of Equivalent Training.\", \"url\": \"https://www.maine.gov/dhhs/dlc/cna-registry/cna-definitions\"}, {\"label\": \"02-380 C.M.R. ch. 5, Maine State Board of Nursing - Regulations Relating to Training Programs and Delegation by Registered Professional Nurses of Selected Nursing Tasks to Certified Nursing Assistants (published by the Board as the adopted rule revised 7/24/25; the document's own closing line reads 'EFFECTIVE: January 1, 2023'). The source of the training-hour floor ('No program shall be conducted that includes less than 70 hours of classroom instruction, 20 hours of skills laboratory and 40 hours of correlated, supervised clinical practice'), the separate 60/20/40 medication-course floor, the admission qualifications, the instructor and ratio rules, the certificate-of-training contents, the out-of-state acceptance test, the four-month temporary listing, the eligibility routes for Registry entry, the additional-skills list and the home-care medication delegation carve-out.\", \"url\": \"https://www.maine.gov/boardofnursing/sites/boardofnursing/files/archive/Chapter_5_Adopted_Rule_rev.7.24.25.pdf\"}, {\"label\": \"10-144 C.M.R. ch. 128, Maine DHHS - Certified Nursing Assistant and Direct Care Worker Registry Rule, effective June 15, 2019. The source of 'No C.N.A. fee. The Department may not charge an applicant or a C.N.A. a fee related to the application and the biennial renewal', the immediate-removal rule for failing to report eight hours of work, the 24-month renewal term and the consequence of filing late, the definition of a non-traditional CNA and the non-traditional test's attempt limits, the three-attempts-in-two-years limit on the Maine competency test, the document lists by applicant type including the out-of-state 'official score report from the testing company', the training program's background-check duty, and the mandatory disclosure list for anyone who asks the Registry about a CNA.\", \"url\": \"https://www.maine.gov/sos/sites/maine.gov.sos/files/content/assets/144c128.docx\"}, {\"label\": \"Maine State Board of Nursing - Prescribed Generalist Curriculum of Nursing Assistant Training Programs (approved June 5, 2019; posted on the Board's CNA Information page as the 9-6-2021 New CNA Curriculum). Establishes the hour table totalling 130 hours, 'Upon successful completion of the program and competency testing, the nursing assistant will be issued a standardized certificate of training by the educational program, who will maintain records of student training and certificates for a minimum of 3 years', 'A minimum passing standard of 70% is required in the class portion of the program', the direct-observation skills evaluation by the instructor, and the five-year currency rule for the nursing assistant textbook.\", \"url\": \"https://www.maine.gov/boardofnursing/sites/boardofnursing/files/2026-06/9-6-2021-%20New%20CNA%20Curriculum.pdf\"}, {\"label\": \"Maine DHHS - Application for Listing on the CNA Registry, Form 060101 Rev 5/2026. The two-page state form. Establishes the five application types (trained in Maine; trained in another state or jurisdiction; trained in military service; student nurse with equivalent training; current RN or LPN), the New Application versus 'Inactive - applying for reinstatement' choice, the five background questions and the court-document requirement, the document lists for Maine-trained and out-of-state applicants, the declaration on misrepresentation, and 'Please allow up to 30 days for your application to be processed.' It carries no fee line of any kind.\", \"url\": \"https://www.maine.gov/dhhs/sites/maine.gov.dhhs/files/inline-files/CNA%20Application%205.2026_0.pdf\"}, {\"label\": \"Maine DHHS - CNA Employment Verification Form (revised 4/30/26). Establishes the renewal work rule in the state's own parenthetical - 'A CNA is required to work at least 8 hours under the direct supervision of a Registered Nurse, in a qualified healthcare setting, in the 24 months prior to their expiration date' - the eight facility types the form recognises, the contracted-position question, and the rule that the signer is 'the facility's management/HR staff not the CNA'.\", \"url\": \"https://www.maine.gov/dhhs/sites/maine.gov.dhhs/files/inline-files/RevLand%20CertCNA%20%20%284%29_0.pdf\"}, {\"label\": \"22 M.R.S. 1812-G, Maine Legislature, Office of the Revisor of Statutes. The registry statute as amended through PL 2025, c. 305, Pt. C - the source of the statutory definition of a certified nursing assistant, the Board's rulemaking authority over eligibility, the $25 provider verification fee that may not be passed on to the CNA, the employer verification duty, the background-check regime, the 5-, 10- and 30-year employment bans under the table of crimes, and the lifetime ban that follows a substantiated finding.\", \"url\": \"https://legislature.maine.gov/statutes/22/title22sec1812-G.html\"}, {\"label\": \"32 M.R.S. 2104, Maine Legislature, Office of the Revisor of Statutes. Subsection 4 is the provision that splits the credential between the two agencies: programs apply to the Department of Health and Human Services, but must carry out 'the curriculum for nursing assistants as prescribed by the board'.\", \"url\": \"https://legislature.maine.gov/statutes/32/title32sec2104.html\"}, {\"label\": \"State of Maine Regulatory Licensing and Permitting - CNA Registry public look-up (ALMS), regulator 'CNA AND DIRECT CARE REGISTRY'. The live search form whose fields and menus establish the search options listed under Verify a license on this page, including the Certified Nurse Aides and Direct Care Workers profession filter.\", \"url\": \"https://www.pfr.maine.gov/almsonline/almsquery/SearchIndividual.aspx?board=6719\"}, {\"label\": \"State of Maine Regulatory Licensing and Permitting - CNA Registry online services (regulator number 6719). The state's own transaction menu, establishing the seven functions available online: apply to be placed on the CNA Registry; renew an active CNA certificate ('Your certificate must currently be active to use this function. You must submit verification of employment'); reinstate an inactive CNA certificate ('Your certificate must be currently inactive'); request removal from the Registry; update contact information; update employment information; and check the status of a CNA Registry application.\", \"url\": \"https://www1.maine.gov/cgi-bin/online/licensing/begin.pl?board_number=6719\"}]",
   "page_url": "https://licensingatlas.com/cna/me-cna/"
  },
  {
   "page_id": "mi-cna",
   "state": "Michigan",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Michigan Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems (BCHS) — Nurse and Medication Aide Section. BCHS took the registry in-house on July 26, 2023: 'On July 26, 2023, the Michigan Department of Licensing & Regulatory Affairs, Bureau of Community and Health Systems, has taken over the Nurse Aide Registry from Headmaster, L.L.P.'",
   "board_url": "https://www.michigan.gov/lara/bureau-list/bchs/nurse-aide-registry",
   "application_url": "https://www.michigan.gov/lara/bureau-list/bchs/nurse-aide-registry",
   "renewal_cycle": "Every two years, and from 2026 there are three things to satisfy rather than two. Rule R 400.315(2): 'An initial or renewal certificate issued after the effective date of these rules is valid for 2 years unless otherwise specified on the certificate.' R 400.315(4) sets the conditions: '(a) Electronic payment of the fee. (b) An attestation that within the last 24-consecutive-month renewal period the individual worked a minimum of 40 hours as a certified nurse aide providing nursing or nursing-related services for monetary compensation. (c) Beginning not less than 12 months after the effective date of these rules, an attestation that the individual has completed at least 12 hours annually of continuing education within the renewal period.' LARA has now fixed the start date for that third condition: 'In accordance with CNA Admin Rule R 400.315, CNAs are required to obtain continuing education (CE) for certificate renewal. CE requirements go into effect on March 23, 2026. Any CNA whose expiration date is on or after March 23, 2026, must meet the requirements prior to their expiration date in order to renew their certificate.' Mechanics: renewal is filed in MI-NATES and 'Renewals can be initiated no earlier than 45 days prior to the certificate expiration date.' LARA emails a renewal notice '45 days before the expiration date listed on the certificate,' but only reaches you if 'your contact information is accurate in the MI-NATES system.' The date arithmetic is the trap: 'A renewal certificate is good for 24 months from the last certificate's expiration date' — renewing early does not push the next expiry further out. 'If a renewal is not submitted timely, or is incomplete, the certificate will lapse the day after the expiration date. An individual may not work as a CNA with a lapsed or expired certificate.' What work counts: 40 hours as a CNA providing nursing or nursing-related services for monetary compensation in the 24-month period. Medication aide hours count too — LARA: 'Working as a CMA a minimum of 40 hours providing nursing or nursing-related services would satisfy this CNA renewal requirement.' The department reserves the right to check: it 'has the authority to require additional information and documentation to verify information within this rule including, but not limited to, proof of employment and continuing education' (R 400.315(6)).",
   "ce_hours": "12 hours a year — 24 hours per two-year renewal — and it is new as of March 23, 2026. LARA: 'Effective March 23, 2026, an attestation must be provided indicating that at least 12 hours annually of continuing education (CE) have been completed within the two-year renewal period [Rule 400.315]. Continuing education must ensure the continuing competence of the nurse aide and must include abuse, neglect, and care plan training.' Its own FAQ states the same duty as a cycle total: renew by 'attesting that you have completed your required 24 hours of continuing education and that you have worked as a nurse aide for at least 40 hours for pay during your last renewal cycle.' Both are LARA's own words and they reconcile — 12 hours annually across a 24-month renewal period is 24 hours. The rule text behind it is R 400.315(4)(c) and (5): the attestation covers 'at least 12 hours annually of continuing education within the renewal period,' and 'Continuing education must ensure the continuing competence of the nurse aide and must include abuse, neglect, and care plan training.' Three required subjects, then, rather than a free choice: abuse, neglect and care plan training. The state provides one course itself, free: 'The Bureau of Community and Health Systems has created a Care Plan Educational Video training module that is accepted for CNA CE in Michigan and is worth 1 nursing contact hour. This activity is virtual/asynchronous (self-learning) and is available at no cost to participants.' To earn the hour, 'participants must watch the Care Plan Educational Video in its entirety, must take and pass the quiz, and submit the survey at the end of the video.' LARA states its approval provenance: 'This nursing continuing professional development activity was approved by the Wisconsin Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation with an expiration date of May 1, 2027.' A note on the start date, recorded both ways: the rule says the CE attestation applies 'Beginning not less than 12 months after the effective date of these rules,' and the rules carry the history line '2023 MR 6, Eff. March 23, 2023' — which sets a floor of March 23, 2024, not a fixed date. LARA has since published March 23, 2026 as the operative start. The two are consistent because the rule says 'not less than,' and this page follows LARA's published date. Separately, a duty on employers rather than aides: long term care facilities must 'Conduct a performance review of all nurse aides at least once every 12 months' and provide in-service education that must 'Ensure the continuing competence of all employed nurse aides' and 'be a minimum of 12 hours per year' under 42 CFR 483.95. That is the facility's obligation; it is not the same thing as the aide's renewal CE, though the hour figure is coincidentally identical.",
   "exam": "Two parts, both from the state's contracted vendor: 'a written/oral exam and clinical skills demonstration exam.' A candidate signs in with the vendor to schedule after completing a Michigan-permitted training program. The two hard limits are in rule, not in vendor policy: 'The maximum number of state-approved testing attempts is 3. After 3 failed attempts an applicant shall successfully complete another nurse aide training program before re-testing' (R 400.311(2)); and 'An applicant shall successfully complete a state-approved testing program within 24 months after completing the nurse aide training program' (R 400.311(3)). A third timing rule bites at the application stage: 'In order to be certified, an applicant shall successfully complete a state-permitted training program and a state approved testing program within the previous 24 months' (R 400.313(4)). Passing the examination does not put you on the registry — the MI-NATES application and the $40 fee do. While you wait: a graduate of a permitted program may work as a temporary nurse aide for up to four months under 42 CFR 483.35(d); miss the four months and 'the individual is no longer eligible to work in a facility as a nurse aide.' LARA's own pages publish no passing score, question count or time limit; the contractor's Michigan Nurse Aide Candidate Handbook (July 2026, version 5.0) does: 'The Knowledge Test consists of 65 multiple-choice questions', with 'a maximum of 60 minutes to complete the 65-question Knowledge Exam', and 'You must receive a 74% or better score to pass the knowledge portion of the exam.' The skill test is three or four randomly selected tasks in 30 minutes.",
   "fees": "$40 to get the certificate, $40 to renew it — the only two state fees on the nurse aide pathway that LARA publishes. Initial certification: 'Submit a new nurse aide application and pay the $40 registration fee via the MI-NATES System.' Renewal: 'Pay the renewal fee ($40).' Reciprocity applicants pay the same $40 registration fee through MI-NATES. Payment is electronic, inside MI-NATES; the renewal rule requires 'Electronic payment of the fee' (R 400.315(4)(a)). Not a state fee and not set by LARA: what the contracted testing vendor charges for the written/oral and clinical skills examinations, and what a training program charges in tuition. LARA does not publish either figure on its Nurse Aide Registry page, and this page does not state one. Reimbursement is someone else's department, and LARA says so: 'The Bureau of Community and Health Systems is not involved in CNA reimbursements. In accord with the Code of Federal Regulations (CFR) 483.152(c), 483.154(c)(2)&(3), and 483.156(b)(4), nurse aides working or have an offer to work in a nursing home, county medical care facility, or hospital long term care unit can be reimbursed for nursing aide training, testing, and registration costs,' with the detail routed to the Michigan Department of Health and Human Services. One more charge with a dollar figure is a penalty rather than a fee: failing to report a change of name or address within 30 calendar days breaches R 400.320(g); the rules do not attach an amount to it and none is stated here.",
   "legal_basis": "[{\"citation\": \"Michigan Administrative Code R 400.301 to R 400.357 — Department of Licensing and Regulatory Affairs, Bureau of Community and Health Systems, Nurse Aide, Nurse Aide Trainer, and Nurse Aide Training Program, Certificate of Registration and Permit Program (2023 MR 6, eff. March 23, 2023)\", \"what_it_governs\": \"The whole certification scheme: definitions (R 400.301); initial application requirements including the three-attempt testing limit and the 24-month testing window (R 400.311); application processing, the 30-day timelines and the contents of the certificate (R 400.313); the two-year certificate term and the renewal conditions of fee, 40 hours of paid work and 12 hours of annual continuing education (R 400.315); the contents of the registry (R 400.317); the placement and permanence of abuse, neglect and misappropriation findings (R 400.319); the aide's own duties including the 30-day name-and-address rule (R 400.320); nurse aide trainer permits (R 400.321 to R 400.329); training program permits, the 75-hour course structure and program duties (R 400.331 to R 400.335); inspections, plans of correction and complaints (R 400.337 to R 400.349); and monitoring, hearings, notices of intent, summary suspension and the neglect-finding removal petition (R 400.351 to R 400.357).\", \"url\": \"https://ars.apps.lara.state.mi.us/AdminCode/DownloadAdminCodeFile?FileName=R%20400.301%20%20to%20400.357.pdf&ReturnHTML=True\"}, {\"citation\": \"Michigan Public Health Code, 1978 PA 368, MCL 333.21913 (Applicant from another state; registration requirements), added by 2017 PA 172, eff. Feb. 19, 2018; amended by 2023 PA 273, eff. Mar. 7, 2024\", \"what_it_governs\": \"Reciprocity, and it is written as a discretion rather than a duty: 'The department may grant a registration to an applicant who is from another state and seeking a registration to practice as a nurse aide if the applicant meets any of the following requirements: (a) The applicant passes a training program that the department determines is equivalent to or exceeds a nurse aide training program offered in this state and the applicant passes a competency examination approved by the department. (b) The applicant's status as a nurse aide in the other state is in good standing, as verified by that state's nurse aide registry, and the department determines that the other state's training program is equivalent to or exceeds a nurse aide training program offered in this state.' The published 39-state approved list is how LARA exercises that equivalence judgment, which is why a state's absence from the list is a refusal rather than a gap. Note also the statutory noun for what a nurse aide holds in Michigan: a registration.\", \"url\": \"https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-21913\"}, {\"citation\": \"Michigan Public Health Code, 1978 PA 368, Article 17, Part 219 — MCL 333.21901 to 333.21925\", \"what_it_governs\": \"The statutory basis for nurse aide regulation in Michigan as a whole. LARA cites this Part as the state-law half of its enforcement authority ('Under state and federal law, 333.21901-333.21925 and 42 USC 1395 i-3 (g) (1) (C). The Bureau may take action against a nurse aide for abuse, neglect and misappropriation of resident property as well as other violations'), and the administrative rules are promulgated 'By authority conferred on the department of licensing and regulatory affairs by section 21923 of the public health code, 1978 PA 368, MCL 333.21923.' Apart from MCL 333.21913, which is set out above, the section texts could not be read from either network location we tried — so the description here is LARA's and the rules' own characterisation of what the Part does, not a summary of statutory text.\", \"url\": \"https://www.legislature.mi.gov/documents/mcl/pdf/mcl-368-1978-17-219.pdf\"}, {\"citation\": \"42 C.F.R. Part 483 — §§ 483.5, 483.35(d), 483.95, 483.151, 483.152, 483.154, 483.156; and 42 U.S.C. § 1395i-3(g)(1)(C) and (g)(1)(D)\", \"what_it_governs\": \"The federal scheme Michigan implements and cites throughout: the four-month temporary nurse aide allowance and the retraining trigger at 483.35(d) and (d)(6); the training program curriculum requirements at 483.152(b) that R 400.335(1)(f) adopts by reference; the registry and removal rules at 483.156, including 483.156(c)(2) which LARA cites when an aide cannot attest to the work requirement; the facility in-service and performance-review duties at 483.95; and the federal enforcement and neglect-petition provisions at 42 U.S.C. 1395i-3(g)(1)(C) and (D). LARA publishes its own compiled copy of the federal nurse aide rules; the federal texts were not separately read for this page.\", \"url\": \"https://www.michigan.gov/lara/-/media/Project/Websites/lara/healthsystemslicensing/Folder2/mdch_na_federal_rules_regulations.pdf\"}]",
   "exam_vendor": "Headmaster, L.L.P., trading as D & S Diversified Technologies, under contract to the Bureau of Community and Health Systems. LARA states the arrangement and the reason for it in the same breath: 'The state of Michigan does not conduct testing of nurse aide candidates. The Bureau of Community and Health Systems contracts with Headmaster, L.L.P. to conduct Nurse Aide Certification Exams. Any questions regarding the testing process should be directed to: D & S Diversified Technologies - Headmaster, Phone: (888) 401-0462, Email: Michigan@hdmaster.com.' Note the division of labour, because it changed in 2023 and is still misreported: the same company used to run the registry as well, and no longer does — 'the Bureau of Community and Health Systems, has taken over the Nurse Aide Registry from Headmaster, L.L.P.' as of July 26, 2023. Today the vendor administers the examination and the state administers the certificate and the registry through MI-NATES. LARA's FAQ names the resulting confusion directly: 'I passed testing with Headmaster, where can I find my nurse aide certificate (CNA) and why am I not listed on the Nurse Aide Registry?' — the answer being that the application and fee in MI-NATES are a separate, later step. The vendor is named here because the state names it; the exam-day details and exam figures on this page that come from the vendor are attributed to its Michigan Nurse Aide Candidate Handbook (July 2026, version 5.0).",
   "training_hours": "75 hours total, with a structure Michigan spells out rather than leaving to the program. Rule R 400.335(1)(d): a permitted nurse aide training program shall 'Provide a course consisting of 16 classroom hours, 16 clinical hours, and any combination of 43 classroom, laboratory, or clinical hours, for a total of 75 hours of training. A minimum of 16 classroom hours are required before the student's direct contact with a resident. Clinical and laboratory hours must be done in-person, but classroom hours may be in-person or virtual. If a virtual classroom is used, there must be a mechanism or method for student feedback and interaction with a nurse aide trainer.' So the fixed floors are 16 classroom and 16 clinical; the remaining 43 hours are the program's to allocate across classroom, laboratory or clinical. Supervision and documentation travel with the hours: the program must 'Provide a permitted nurse aide trainer during classroom hours' and 'Provide a permitted nurse aide trainer onsite and engaged during laboratory and clinical hours,' with 'sufficient permitted nurse aide trainers to meet the needs of the nurse aide candidates during classroom, laboratory, and clinical hours,' and 'Classroom, laboratory, and clinical hours must be documented and available to the department upon request.' Curriculum: the program must 'Comply with the curriculum of the state-permitted training program requirements listed in 42 CFR 483.152(b) and the state-approved training program curriculum.' A supplemental instructor may assist a permitted trainer only if they are 'a licensed health professional with 1 year of experience in the field that he or she is licensed in and under the supervision of a permitted nurse aide trainer.' The same 75-HOUR number governs incoming reciprocity: LARA lists among its reciprocity criteria that the other state's scheme 'Requires a minimum of 75 course hours prior to taking a competency evaluation examination' and 'Does not allow candidates to exempt out of the training course hours or testing.'",
   "lapse_rule": "Two regimes, split at the 24-MONTH mark, and the second one ends your registry listing. The certificate lapses immediately: 'If a renewal is not submitted timely, or is incomplete, the certificate will lapse the day after the expiration date. An individual may not work as a CNA with a lapsed or expired certificate.' Lapsed less than 24 months: the individual 'will follow the standard renewal process,' but the employment attestation is measured against the certificate, not against today — 'The employment must have occurred within the 24 month period preceding the certificate expiration date and cannot have occurred more than 24 months prior to the date the late renewal application is being submitted on. If the employment did not occur within that timeframe, the individual cannot renew their certificate and must be removed from the registry in accordance with 42 CFR Part 483, § 483.156(c)(2).' And renewing late buys no extra time: 'If a lapsed certificate is renewed, the renewed certificate will only be valid for 24 months from the last certificate's expiration date.' Lapsed more than 24 months, or unable to attest to the work: 'An individual must be removed from the registry and must retake a state-approved nurse aide training program and competency examination as required by 42 CFR Part 483, § 483.35(d)(6). An individual must apply as a new initial certification after successfully retaking the state-approved nurse aide training program and competency examination.' LARA's FAQ says the same in plain terms: 'If your CNA certification has been lapsed for greater than two years you must retake a state-approved training course and retake the exam. If lapsed less than 2 years, you can renew via MI-NATES, as long as you can attest to completing your required 24 hours of continuing education and that you have worked as a nurse aide for at least 40 hours for pay during your last renewal cycle.' A consequence most people discover too late: Michigan does not keep your history. 'The State of Michigan does not maintain a history of lapsed or expired registrations. A lapsed record may be stored in our system up to 7 years, however, the details regarding specific lapsed and active time periods are not maintained.' LARA gives that same answer to former aides needing proof of past service and to employers checking whether a hire has ever lapsed. Discipline is a different kind of ending: 'Nurse aides that have been found to have abused or misappropriated the property of a resident will be revoked on the nurse aide registry permanently and the finding will be permanently listed on the registry.' Neglect is the one reversible finding — revocation runs 'for a minimum of 1 year,' and under 42 U.S.C. 1395i-3(g)(1)(D) and rule R 400.351(4)(a)(b) the aide 'may petition the Bureau by sending a request to the manager of the Nurse and Medication Aide Section to have the negative finding removed from the registry. The request will be reviewed within 30 days.' All such requests go through MI-NATES. Rule R 400.319 sets the recording rule: findings of abuse, neglect or misappropriation go on the registry 'within 10 business days of the finding and must remain in the registry permanently, unless the finding was made in error, the individual was found not guilty in a court of law, or the department is notified of the individual's death.'",
   "reciprocity": "Michigan publishes a closed list of approved states, and being off it is a flat no. 'For applicants that currently hold a nurse aide certification in another state, the State of Michigan will grant reciprocity under the conditions listed in Section 333.21913 of the Michigan Public Health Code. Candidates seeking reciprocity must be in good standing from a state that meets the Michigan requirements for reciprocity to be eligible for certification in Michigan.' The statute itself is permissive, which is why the list can be closed. MCL 333.21913: 'The department may grant a registration to an applicant who is from another state and seeking a registration to practice as a nurse aide if the applicant meets any of the following requirements: (a) The applicant passes a training program that the department determines is equivalent to or exceeds a nurse aide training program offered in this state and the applicant passes a competency examination approved by the department. (b) The applicant's status as a nurse aide in the other state is in good standing, as verified by that state's nurse aide registry, and the department determines that the other state's training program is equivalent to or exceeds a nurse aide training program offered in this state.' The published state list is LARA's determination of equivalence under that section. The 39 approved states, in LARA's own list under the heading 'The following States meet or exceed the Michigan requirements': Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin and Wyoming. LARA then states the negative itself: 'A candidate that has passed training and testing in one of the above states is eligible to apply for a Michigan CNA certificate via the MI-NATES system. A candidate that did not undergo training and testing from a State listed above is not eligible for reciprocity.' Ten states are absent from that list — Delaware, Florida, Maryland, Massachusetts, Minnesota, Montana, North Carolina, Vermont, Virginia and West Virginia — and an aide who trained and tested in one of them therefore does not qualify for the reciprocity route as the list stands. What the list is measuring: 'Michigan requirements for reciprocity includes, but not limited to: The training program is consistent with the Federal Code of Regulations. Requires a minimum of 75 course hours prior to taking a competency evaluation examination. Does not allow candidates to exempt out of the training course hours or testing.' How to file: the same MI-NATES sequence as a new applicant — MILogin account, MI-NATES access and profile, then 'Submit a new nurse aide application and pay the $40 registration fee.' The rule behind it, R 400.311(4), excuses the Michigan training-and-testing requirement for an applicant who either holds an active nurse aide certificate from another state, in good standing there, 'and that state's training program is recognized by the department,' or has completed a recognised out-of-state training program and passed Michigan's approved testing program. Going the other way, Michigan will not help with paperwork: 'The Bureau of Community and Health Systems (BCHS) CNA registry functions are paperless and are online only. Therefore, BCHS no longer completes reciprocity forms for other states and does not accept or process any paperwork related to an actively certified Michigan nurse aide seeking reciprocity in another state. For reciprocity purposes, out of state regulatory authorities should check the BCHS online CNA Registry to verify the current status of any Michigan nurse aides.'",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Michigan LARA, Bureau of Community and Health Systems — Nurse Aide Registry. The core page and the source of most of this page. Establishes the July 26, 2023 transfer of the registry from Headmaster to BCHS and the MI-NATES system; the CE notice ('CE requirements go into effect on March 23, 2026'); the age rule ('There is no age requirement for training and testing, only employment'); the registry description and the bar on working with a lapsed, expired, inactive, surrendered or revoked status; the testing contract ('The state of Michigan does not conduct testing of nurse aide candidates. The Bureau of Community and Health Systems contracts with Headmaster, L.L.P.') and the vendor's contact details; the initial-certification steps and the '$40 registration fee'; the full renewal sequence including the 45-day window, the 40-hours-of-paid-work attestation, the CE attestation and 'Pay the renewal fee ($40)'; the lapsed-certificate rules on both sides of 24 months; the Care Plan Educational Video and its Wisconsin Nurses Association approval expiring May 1, 2027; the approved-state reciprocity list and the three Michigan reciprocity criteria including 'a minimum of 75 course hours'; the statement that BCHS no longer completes reciprocity forms for other states; the name-change rule under R 400.320(g); the employer verification instructions; the facility duties of annual performance review and 12 hours of in-service; the enforcement and permanent-revocation rules; and the neglect petition procedure.\", \"url\": \"https://www.michigan.gov/lara/bureau-list/bchs/nurse-aide-registry\"}, {\"label\": \"Michigan LARA — Michigan Certified Nurse Aide Registry FAQ's, January 22, 2026. Establishes the MI-NATES access sequence; 'Passing testing is one portion of obtaining a certification'; how to print the certificate ('View/Print Certificate'); the renewal attestation in cycle terms ('your required 24 hours of continuing education and that you have worked as a nurse aide for at least 40 hours for pay during your last renewal cycle') and the 45-day early-renewal window; the 45-day email notice; the two-year lapse split ('If your CNA certification has been lapsed for greater than two years you must retake a state-approved training course and retake the exam'); the out-of-state applicant instructions; that 'The State of Michigan does not maintain a history of lapsed or expired registrations' and the 7-year storage note, given as the answer both to former aides and to employers; and that CMA hours satisfy the CNA renewal work requirement.\", \"url\": \"https://www.michigan.gov/lara/-/media/Project/Websites/lara/bchs/Folder2/Nurse-Aide_MI-NATES-FAQs-01-22-26.pdf\"}, {\"label\": \"Michigan Administrative Code R 400.301 to R 400.357 (Nurse Aide, Nurse Aide Trainer, and Nurse Aide Training Program, Certificate of Registration and Permit Program), from the LARA Administrative Rules service. Establishes the rule set's own title and authority line ('By authority conferred... by section 21923 of the public health code, 1978 PA 368, MCL 333.21923'); R 400.311 (training plus testing, the three-attempt limit, the 24-month testing window, and the out-of-state exemption); R 400.313 (30-day processing, completeness, the 24-month recency rule, the contents of the certificate, and the no-appeal-but-refile rule); R 400.315 (two-year term, the three renewal conditions, and the department's audit power); R 400.317 (registry contents and the power to contract out daily operation); R 400.319 (10 business days and permanence of findings); R 400.320 (the aide's duties, including the financial-exploitation bar and the 30-day change rule); and R 400.335(1)(d) (the 16 classroom + 16 clinical + 43 flexible = 75 hour course, the 16 classroom hours before resident contact, and the in-person requirement for clinical and laboratory hours).\", \"url\": \"https://ars.apps.lara.state.mi.us/AdminCode/DownloadAdminCodeFile?FileName=R%20400.301%20%20to%20400.357.pdf&ReturnHTML=True\"}, {\"label\": \"Michigan LARA — Michigan Nurse Aide Registry (the public register). Establishes the search fields (registration/permit type, registration/permit number, last name, first name, program name, city, status), the Excel export, the six registration and permit types covered, the count of active nurse aide records at the time of reading, the standing notice that lapsed, expired, inactive, suspended, surrendered or revoked holders may not work in that capacity, and LARA's disclaimer that users must determine whether the information is still accurate, current and complete.\", \"url\": \"https://nurseaideregistry.apps.lara.state.mi.us/\"}, {\"label\": \"Michigan LARA — Nurse Aide Federal Rules & Regulations, Part 483 (LARA's own compiled copy of the federal rules it cites throughout the Nurse Aide Registry page: 42 CFR 483.5, 483.35, 483.95, 483.152(c), 483.154(c)(2) and (3), 483.156(b)(4) and 483.156(c)(2)).\", \"url\": \"https://www.michigan.gov/lara/-/media/Project/Websites/lara/healthsystemslicensing/Folder2/mdch_na_federal_rules_regulations.pdf\"}, {\"label\": \"Michigan Legislature — MCL 333.21913 (Applicant from another state; registration requirements). Establishes the reciprocity provision LARA cites, verbatim: 'The department may grant a registration to an applicant who is from another state and seeking a registration to practice as a nurse aide if the applicant meets any of the following requirements: (a) The applicant passes a training program that the department determines is equivalent to or exceeds a nurse aide training program offered in this state and the applicant passes a competency examination approved by the department. (b) The applicant's status as a nurse aide in the other state is in good standing, as verified by that state's nurse aide registry, and the department determines that the other state's training program is equivalent to or exceeds a nurse aide training program offered in this state.' History: added by 2017 PA 172, effective February 19, 2018; amended by 2023 PA 273, effective March 7, 2024.\", \"url\": \"https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-21913\"}, {\"label\": \"Michigan Legislature — Michigan Public Health Code, 1978 PA 368, Article 17, Part 219 (MCL 333.21901 to 333.21925). The statutory Part LARA cites for its enforcement authority, and MCL 333.21923 for the rulemaking authority under which R 400.301 to R 400.357 were promulgated. Recorded as the citation LARA and the rules give; apart from MCL 333.21913 above, we were not able to open the text of these sections.\", \"url\": \"https://www.legislature.mi.gov/documents/mcl/pdf/mcl-368-1978-17-219.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/mi-cna/"
  },
  {
   "page_id": "mn-cna",
   "state": "Minnesota",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Minnesota Department of Health (MDH), Health Regulation Division — Nurse Aide Registry. MDH operates the registry itself; the competency examination is run by a contractor MDH selected: 'MDH selected D&SDT-Headmaster as the test contractor for placement on the Minnesota Nurse Aide Registry. Testing on the Headmaster platform began on Feb. 1, 2022.' The authority to contract is statutory — 'The commissioner of health may contract with outside parties for the purpose of implementing the provisions of this section' (Minn. Stat. 144A.61, subd. 1).",
   "board_url": "https://www.health.state.mn.us/facilities/providers/nursingassistant/index.html",
   "application_url": "https://www.health.state.mn.us/facilities/providers/nursingassistant/getonregistry.html",
   "renewal_cycle": "Every 24 months, and the test is paid work — not education and not a fee. The state-linked candidate handbook states the standing condition: 'To stay on the registry as a nurse aide: You must work at least 8 hours as a paid nursing assistant every 24 months. (A 24-month lapse of employment will result in an expired registry status.) You must provide a copy of a recent pay stub from your employer. If you are not working in a nursing home or an assisted living facility, you must provide a job description to show that you are providing assistance with the activities of daily living.' Renewal is filed in MDH'S own registry system, and MDH notifies you first: 'You have received an email and text notification from MDH to renew your certificate.' The application asks for 'your employment history for the past 24 months' and requires you to 'Upload the most recent pay stub (PDF only) that provides documentation to verify nursing or nursing-related services were performed for monetary compensation for at least one documented day (e.g., 8 consecutive hours) during the previous 24 months.' What counts and what does not: 'Providing assistance with activities of daily living (ADL) care is an allowed service. Orientation, training, or in-service hours are not allowed.' You may also be asked to upload a job description listing the specific direct care services performed. The filing is signed electronically by typing your full name. Processing: 'Please allow up to 30 business days for MDH to complete their review.' The three outcomes are not two — MDH publishes a middle one that catches people out: 'Approved: the application was approved, and you are active on the registry. Processed: the application was approved; however, you remain inactive on the registry. This may be due to submitted employment information that could not bring your certificate to an active status. Denied: the application was denied.' Corrections are handled inside the system: if MDH needs something, it messages you through the registry dashboard and you resubmit.",
   "ce_hours": "None for the registry. The state-linked candidate handbook is explicit that continuing education is not a registry condition and that the training duty runs to the employer instead: 'There is no requirement to submit in-service documentation related to the Nursing Assistant Registry. Nursing and boarding care homes must comply with state and federal regulations regarding in-service training.' Nothing in Minn. Stat. 144A.61 or 144A.611 imposes continuing education on a nursing assistant, and MDH's renewal application asks only for employment history and a pay stub — it has no education field, and MDH's instructions state the opposite for in-service time, which does not even count as qualifying work: 'Orientation, training, or in-service hours are not allowed.' Sources checked: Minn. Stat. 144A.61 and 144A.611 in full, MDH's Nurse Aide Registry landing page, its Who Can Work, Get on the Registry, Training and Testing, Testing Information, NATCEP FAQ, Curricula and Contact pages, the MDH renewal and interstate-endorsement tutorials, and the Minnesota Nurse Aide Candidate Handbook (version 8.0, updated June 11, 2026).",
   "exam": "Two parts, both required: a computer-delivered knowledge test and an observed skill test. The state-linked candidate handbook states the consequence: 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Minnesota Nurse Aide Registry.' Knowledge test — 'You will have two hours to complete the 70-question exam' and 'You must have a score of 74% or better to pass the knowledge portion of the exam.' MDH publishes the same figure as a raw count: 'There are 70 questions on the test. As of August 5, 2024, candidates must answer 52 questions correctly to obtain a passing score of 74% on the knowledge test.' The handbook publishes the subject-area blueprint question by question: Basic Nursing Skills 15, Infection Control 8, Safety 8, Care Impaired 6, Resident Rights 5, Role and Responsibility 5, Aging Process and Restorative Care 4, Communication 4, Data Collection 4, Disease Process 4, Personal Care 4, Mental Health 3. MDH also publishes the reading level: 'between 5.1 to 5.7 on the Flesch-Kincaid reading level scale, meaning a less than 6th grade reading level.' Languages — 'In addition to English, the Knowledge Exam is only offered in the following alternate languages: Spanish, Somali, Hmong,' a choice MDH ties to statute: 'Minnesota Statutes, section 144A.61, subdivision 3a identifies “commonly spoken” languages... Additional languages may be added in the future.' The handbook itself remains English-only. Skill test — the first task is drawn from a fixed mandatory set with hand washing built in ('Assist a Resident with the use of a Bedpan, Measure and Record Urine Output, and Hand Washing'; 'Catheter Care for a Female Resident and Hand Washing (demonstrated on a manikin)'; a Don PPE / empty urinary drainage bag / Doff PPE sequence; or 'Perineal Care for a Female Resident and Hand Washing (demonstrated on a manikin)'), and then 'You will also receive an additional two or three randomly selected tasks from the Skill Task listing.' Tasks are performed on a live resident actor except catheter care and perineal care, which use a manikin, and an RN Test Observer records what the candidate does while 'D&SDT-HEADMASTER scoring teams will officially score and double-check your test.' Attempts — 'You have four (4) attempts to pass the knowledge exam and three (3) attempts to pass the skills exam' within 24 months of training completion or of the first attempt as a challenge candidate; 'If you have exhausted your knowledge OR skill attempts prior to the 24-month cycle ending, you MUST complete another MDH-approved training program BEFORE you are eligible to re-test.' Test-day rules worth knowing before you pay: candidates must arrive 20 minutes early ('If you arrive late, you will not be permitted to take the test'), must be in full scrubs and closed-toe shoes with long hair tied back, and must present an original, signed, non-expired US government-issued photo ID — 'Photocopies, faxes, images, or mobile or electronic/digital versions (for example, Apple or Google Wallet) of IDs are not allowed.' MDH adds a cheating penalty: 'Candidates who have cheated on either the knowledge or skills exam will be exempt from any testing opportunities for 45 calendar days.'",
   "fees": "Minnesota charges nothing for the registry itself. MDH states it in capitals on its own page: 'There is NO PROCESSING FEE for the Minnesota Registry.' That is not a Minnesota courtesy — the federal rule the registry is built on forbids it: 'The State may not impose any charges related to registration on individuals listed in the registry' (42 C.F.R. 483.156(b)(4)). No fee appears for initial listing, renewal or interstate endorsement in Minn. Stat. 144A.61, in Minn. Stat. 144A.611, on any MDH nurse aide page, or in the MDH registry tutorials, all checked. What does cost money is the test, and the price depends on which testing server you are in. For the Minnesota State Colleges and Universities server the state publishes no figure and routes the question to the site: 'For information on testing fee payments, please contact the test site where you want to schedule your test.' For the in-facility server MDH publishes the candidate price and the underlying service prices: 'Knowledge Test Price – $60' and 'Skills Test Price – $100,' charged to 'All in-facility testing students' alike; the per-service prices behind them are '$23 per Knowledge Test administered by facility Knowledge Test Proctor (KTP)', '$60 for virtual Knowledge Test if administering the Skills Test only, or if using a KTP from the statewide pool', '$40 per Skills Test administered using facility test site, certified RN, and Actor', '$70 per Skills Test if using test site, certified RN and Actor with oversight and interrater reliability reporting' and '$100 per Skills Test if using a certified RN and Actor from the statewide pool.' MDH disclaims control of the number: 'These costs may be altered over time to ensure testing costs are covered. The Minnesota Department of Health does not determine cost, nor will the Minnesota Department of Health be involved in any cost adjustments.' Tuition is also not a state price: 'The cost of training and testing varies by training sites. Please contact the training site for the cost of their training and testing programs.' Two Minnesota rules that can make the whole thing free. First, a prohibition: 'A Nurse Aide who is employed by or has received an offer of employment from a certified nursing home or boarding care home as a Nurse Aide prior to beginning a Nurse Aide Training and Competency Evaluation Program (NATCEP) may not be charged for any portion of the training program and the competence evaluation.' Second, a reimbursement right with a statutory deadline: a nursing assistant who completes an approved program or evaluation 'shall be reimbursed by the nursing home or certified boarding care home for actual costs of tuition and textbooks and reasonable expenses for the competency evaluation or the training program and competency evaluation 90 days after the date of employment, or upon completion of the approved training program, whichever is later' (Minn. Stat. 144A.611, subd. 2(a)). MDH puts the clock on the aide too: 'The Nurse Aide has one (1) year from passing the test and placement on the Registry to turn in receipts requesting reimbursement. The facility has 90 days to reimburse the Nurse Aide. If the Nurse Aide does not remain employed as a Nurse Aide for 90 days, the nursing home is under no obligation to reimburse the Nurse Aide.' Only certified nursing homes or boarding care homes owe the reimbursement.",
   "legal_basis": "[{\"citation\": \"Minn. Stat. 144A.61 (Nursing Assistant Training), 2025 edition\", \"what_it_governs\": \"The whole Minnesota nurse aide scheme: the commissioner of health's duty to implement the OBRA-87 training, testing and registry provisions and the power to contract with outside parties (subd. 1); the definition of 'nursing assistant', which covers nursing pool employees and excludes licensed health professionals (subd. 2); curricula development (subd. 3); approval of the competency evaluation program, the rule that tests 'may only be administered by technical colleges, community colleges, or other organizations approved by the commissioner of health', the duty to offer written portions in commonly spoken languages, and the mandatory interstate approval without a competency evaluation (subd. 3a); medication-administration curricula for unlicensed personnel (subds. 3b and 3c); the four-month post-hire deadline (subd. 6a); the correction order and $300 fine (subd. 7); the Church of Christ, Scientist exemption (subd. 8); and the duty to accept electronic interstate endorsement filings (subd. 9).\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/144A.61\"}, {\"citation\": \"Minn. Stat. 144A.611 (Reimbursable Expenses for Nursing Assistant Training and Competency Evaluations), 2025 edition\", \"what_it_governs\": \"The nursing assistant's right to be reimbursed by the nursing home or certified boarding care home for actual tuition, textbook and reasonable evaluation costs 90 days after the date of employment or on completion of the approved program, whichever is later; direct reimbursement of a funding entity where the aide did not pay; rulemaking to prevent double reimbursement and to allow retraining after an absence of at least 24 months; and reimbursement of adult basic education components capped at 30 percent of total training and testing cost.\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/144A.611\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal floor Minnesota adopts unchanged: a program must 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training', with supervised practical training defined as training 'in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse', plus the instructor qualifications (a registered nurse with at least 2 years of nursing experience, at least 1 year in long-term care facility services) that MDH restates as its own instructor rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"42 C.F.R. 483.156 (Registry of nurse aides)\", \"what_it_governs\": \"The registry frame itself: the state's duty to establish and maintain the registry and keep accountability even where daily operation is contracted to a non-state entity; the bar on charging individuals — 'The State may not impose any charges related to registration on individuals listed in the registry'; the rule that only the state survey and certification agency may place abuse, neglect or misappropriation findings on the registry; the 24-consecutive-month removal rule; and the permanent retention of maltreatment findings.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}]",
   "exam_vendor": "D&S Diversified Technologies (D&SDT)-Headmaster, under contract to MDH. The state names the contractor and dates the arrangement: 'MDH selected D&SDT-Headmaster as the test contractor for placement on the Minnesota Nurse Aide Registry. Testing on the Headmaster platform began on Feb. 1, 2022.' The contractor's Minnesota page states the same relationship from the other side: 'Headmaster is honored to be approved by the Minnesota Department of Health to offer Certified Nurse Aide Testing Services to the Minnesota Health Care Community.' Minnesota does not use the NNAAP — the test is a Minnesota-specific instrument built for the state, and MDH keeps editorial control of it: 'Yes, MDH can review, reword, change, or delete any of the test questions. As of May 2022, MDH has removed test questions,' and 'MDH meets with Headmaster twice a month to review test questions and determine why candidates may not be passing certain questions.' Question selection runs through a state panel: 'Each state convenes a group of experts, called a Test Advisory Panel (TAP)... The Minnesota TAP chose the questions that are included on the Minnesota Nurse Aide Test based on a review of several Minnesota nurse aide program curricula.' Two separate testing servers, and the choice is not reversible: 'Students who plan to test at an in-facility test site should be enrolled in the In-Facility Server. Students who wish to test at a MN State Colleges and Universities test site should be enrolled in the Minnesota State server. Once a student has tested in a server, they must complete all test attempts in the same server.' MDH approves the test sites themselves: 'MDH approves all testing sites for Minnesota, with support from Headmaster.'",
   "training_hours": "75 clock hours total, of which at least 16 must be supervised practical training with a live person. MDH states it in its own words on the page that tells providers how to open a program: 'An approved nurse aide training and competency evaluation program must be at least 75 clock-hours in length. Training includes 16 hours of supervised practical training with a live person in a laboratory or other setting and curriculum instruction/skills totaling 75 hours.' MDH repeats the same split against every curriculum it has approved — the Minnesota-Approved Training Curricula page attaches the line 'At least 16 of the 75 hours are supervised practical training with a live person in a lab or other setting' to the Minnesota State Nurse Aide Curriculum (2024 Edition), Ready CNA, the AHCA 'How to be a Nurse Assistant' 8th edition, OnTrack Nursing Assistant Training, Hartman's Nursing Assistant Care and the Sanford Health program alike. Minnesota sits at the federal floor and says so: MDH's NATCEP FAQ reproduces 42 C.F.R. 483.152(a), which requires a program to '(1) Consist of no less than 75 clock hours of training' and '(3) Include at least 16 hours of supervised practical training,' and directs programs to that section 'for the complete requirements.' MDH does not publish a separate Minnesota classroom/clinical breakdown beyond the 16-hour supervised-practical floor, and no Minnesota statute or rule we checked sets a different figure — Minn. Stat. 144A.61 assigns curricula development to the chancellor of vocational technical education (subd. 3) and sets no hour count. Two counting rules MDH publishes that change what the 75 hours can contain: self-study does not count — 'Self-study or self-reported hours are not eligible to count towards the 75-hour total. If time spent on study guides can be tracked or recorded in an online learning management system, this would be allowable'; and lab skills practice is not supervised practical training — 'Skills training with candidates in the lab does not count toward the 16 hours of SPT required by federal regulation 483.152. These times must be identified separately.' The 16 hours may be split across settings: 'Some hours can be completed in the lab setting and some can be completed in a facility, such as a long-term care facility, assisted living facility, or hospital.'",
   "lapse_rule": "Twenty-four consecutive months without paid nursing work ends active status: 'A 24-month lapse of employment will result in an expired registry status' (state-linked candidate handbook). The federal rule behind it requires the state to remove those entries: the State must determine which individuals 'do not qualify to remain on the registry because they have performed no nursing or nursing-related services for a period of 24 consecutive months,' and 'The registry must remove entries for individuals who have performed no nursing or nursing-related services for a period of 24 consecutive months, unless the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property' (42 C.F.R. 483.156(b)(3), (c)(2)). Getting back on means testing again — both parts. The handbook's eligibility list treats an expired Minnesota aide as a testing candidate, not a paperwork case: you may apply to take the exam if you 'Prove you have previously completed a state-approved nurse aide training program, have taken and passed the Nurse Aide Competency Exam (both the Knowledge and Skills exams), and are on the Minnesota Nurse Aide Registry with an expired registry status. You will be required to take both the Knowledge and Skills exams.' Someone who cannot prove the earlier training re-enters as a test-out/challenge candidate — the handbook lists 'If you have not worked as a nurse aide in the last 24 months' as a challenge-candidate example — and also takes both parts. A separate lapse runs on the testing side rather than the registry side: exhausting the four knowledge attempts or the three skills attempts inside the 24-month testing cycle forces a whole new MDH-approved training program before any further test, and completing a new program 'will void all past training and testing attempts.' Registry status can also end for cause rather than for time — a substantiated maltreatment finding stays on the record and bars nursing-home work outright.",
   "reciprocity": "Minnesota calls it interstate endorsement, it is free, and the statute makes it mandatory rather than discretionary: 'The commissioner of health shall approve a nursing assistant for the registry without requiring a competency evaluation if the nursing assistant is in good standing on a nursing assistant registry in another state' (Minn. Stat. 144A.61, subd. 3a(c)). A second subdivision was added to keep it off paper: 'The commissioner of health must accept electronic transmission of applications and supporting documentation for interstate endorsement for the nursing assistant registry' (subd. 9). MDH's own eligibility condition adds a recency test the statute does not state: you must 'Currently be in good standing on the nursing assistant registry in another state and have worked a minimum of 8 hours as a nursing assistant in that state in the past 24 months,' and the endorsement application cannot even be filed otherwise — 'You cannot submit the Interstate Endorsement application if you have not worked or tested in the state from which you are endorsing during the last 24 months.' The reported employment location must be in the same state you are endorsing from. Listing comes before working: 'If you are transferring to Minnesota from another state, you must be on the Minnesota nursing assistant registry before you can work as a nursing assistant in Minnesota.' Cost: 'There is NO PROCESSING FEE for the Minnesota Registry.' Processing: 'Please allow 30 business days for MDH to review your application,' after which 'your dashboard will show the certificate number and expiration date.' One routing rule that sends people to the wrong form: 'If you were an active nurse aide on the registry at any point in time, please apply through the registrant type: Certified Nurse Aide and not through the Interstate Endorsement Candidate.' A conflict recorded both ways, not resolved: the statute says the commissioner shall approve a good-standing out-of-state aide 'without requiring a competency evaluation,' and MDH's own requirements page lists interstate good standing as a stand-alone route onto the registry — but the closing 'Next Steps' list in MDH's interstate-endorsement tutorial states 'If you wish to work as a nurse aide in Minnesota, you must pass the Minnesota knowledge test and skills test.' Both are MDH-published. Anyone endorsing in should confirm with the Nurse Aide Registry which applies to them before paying for a test. Two filing channels are also published at once: the older Get on the Registry page says to 'Complete the Interstate Endorsement Forms (PDF)' and 'Submit the Interstate Endorsement Forms electronically via email at: health.FPC-NAR@state.mn.us,' while the current MDH tutorial walks through registering in the online registry and selecting the registrant type 'Interstate Endorsement Candidate.' The tutorial is the newer instruction; the forms page carries a 2022 update stamp.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Minnesota Department of Health — Nurse Aide Registry (the landing page). Establishes 'The Nurse Aide Registry lists nurse aides who have met Minnesota training and/or testing standards to work in nursing homes and certified boarding care homes', 'This is an online registry. Nurse aides, employers, and others can check the registry by using the Minnesota Department of Health's (MDH) online system and the nurse aide's certificate number', the link set for aides, employers and training programs, and the separate Trained Medication Aide rulemaking and medication-curriculum-approval items.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/index.html\"}, {\"label\": \"MDH — How to Get on the Nursing Assistant Registry. Establishes the three qualifying routes ('Successfully complete an approved nursing assistant training and competency evaluation program in Minnesota... or Successfully pass the Minnesota approved competency test... or Currently be in good standing on the nursing assistant registry in another state and have worked a minimum of 8 hours as a nursing assistant in that state in the past 24 months'), automatic placement on completing training or passing the test, 'Minnesota issues to each nursing assistant a unique certificate number', the transfer rule 'you must be on the Minnesota nursing assistant registry before you can work as a nursing assistant in Minnesota', and 'There is NO PROCESSING FEE for the Minnesota Registry.'\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/getonregistry.html\"}, {\"label\": \"MDH — Who Can Work as a Nurse Aide? Establishes the four-month post-hire window and the facility's competence duty, the temporary-agency rule ('Persons working for a temporary agency must be on the Registry before they are eligible to work'), the documented-but-not-yet-listed route with test scores, and the challenge-candidate bar ('may not work as a nurse aide until they have passed both the knowledge and skills portions of the test... They do not have 4 months to get on the Registry').\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/whocanwork.html\"}, {\"label\": \"MDH — Nurse Aide Training and Testing. Establishes the prohibition on charging an already-hired or offered aide for the training program and competency evaluation, 'The cost of training and testing varies by training sites', the reimbursement timetable (one year to submit receipts, 90 days for the facility to pay, 90 days of employment), and the 24-month testing cycle with four knowledge and three skills attempts.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/training.html\"}, {\"label\": \"MDH — Nurse Aide Registry Testing Information. Establishes 'MDH selected D&SDT-Headmaster as the test contractor for placement on the Minnesota Nurse Aide Registry. Testing on the Headmaster platform began on Feb. 1, 2022', the two-server system and the rule that a candidate must finish all attempts in one server, 'MDH approves all testing sites for Minnesota, with support from Headmaster', the 70-question / 52-correct / 74% pass standard as of August 5, 2024, the Flesch-Kincaid reading level, MDH's editorial control over questions and the twice-monthly item review, the Test Advisory Panel process, the Spanish/Somali/Hmong knowledge tests and the statutory 'commonly spoken' languages hook, and the 45-calendar-day exclusion for cheating.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/testing.html\"}, {\"label\": \"MDH — In-Facility Testing. Establishes the published in-facility testing prices ('Knowledge Test Price – $60', 'Skills Test Price – $100') and the per-service prices behind them, MDH's disclaimer that 'The Minnesota Department of Health does not determine cost', and the note that 'Applications are no longer being accepted for in-facility testing.'\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/infacility.html\"}, {\"label\": \"MDH — How to Start a Nurse Aide Training and Competency Evaluation Program (NATCEP). Establishes the Minnesota program standard in MDH's own words: 'An approved nurse aide training and competency evaluation program must be at least 75 clock-hours in length. Training includes 16 hours of supervised practical training with a live person in a laboratory or other setting and curriculum instruction/skills totaling 75 hours', plus the RN instructor qualifications, the Train the Trainer requirement, the two-year enforcement bar on nursing-home-operated programs, and the 90-day federal approval window.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/starttrainprog.html\"}, {\"label\": \"MDH — Minnesota-Approved Training Curricula. Establishes the approved curriculum list (Minnesota State Nurse Aide Curriculum 2024 Edition, Ready CNA, AHCA 'How to be a Nurse Assistant' 8th ed., OnTrack Nursing Assistant Training, Hartman's Nursing Assistant Care, Sanford Health) and repeats against each of them that the curriculum 'must be at least 75 hours in length. At least 16 of the 75 hours are supervised practical training with a live person in a lab or other setting', together with which curricula carry a Train the Trainer component.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/curriculum.html\"}, {\"label\": \"MDH — Frequently Asked Questions about NATCEPs. Establishes that self-study and self-reported hours do not count toward the 75-hour total, that lab skills practice does not count toward the 16 supervised-practical hours, that supervised practical training may be split between lab and facility settings, that a student who does not complete or fails the training program may keep working only in another department, and that a student who completed training and failed a test may keep providing direct care until attempts are exhausted or the four-month mark; reproduces 42 C.F.R. 483.152(a).\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/faq.html\"}, {\"label\": \"MDH — Nurse Aide Registry: Searching the Registry. Establishes the two ways to search ('Certificate number, or Last name, first name, and last 4 digits of social security number') and the link to the registry search itself.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/checkregistry.html\"}, {\"label\": \"MDH — Nurse Aide Registry: Filing a Complaint. Establishes that complaints go to the Office of Health Facility Complaints, that 'An investigation must be completed before a finding can be substantiated and entered onto the registry', that the verification tool will not print a document where a finding exists, and that 'If there is a finding of maltreatment on the registry, the nurse aide is prohibited from working in a nursing home or certified boarding care home.'\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/findings.html\"}, {\"label\": \"MDH — Nurse Aide Registry Tutorial: Submitting Your Renewal Application (PDF). Establishes the renewal mechanics: MDH's email and text notice to renew, the 24-month employment history, the pay-stub upload requirement 'to verify nursing or nursing-related services were performed for monetary compensation for at least one documented day (e.g., 8 consecutive hours) during the previous 24 months', that ADL care counts while 'Orientation, training, or in-service hours are not allowed', the typed electronic signature, the 30-business-day review, and the Approved / Processed / Denied statuses including the 'Processed' status that leaves an aide inactive.\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/docs/tutorial/renewalapp.pdf\"}, {\"label\": \"MDH — Nurse Aide Registry Tutorial: Submitting Your Interstate Endorsement Application (PDF). Establishes the 'Interstate Endorsement Candidate' registrant type, the requirement that the reported employment location be in the state you are endorsing from, the 30-business-day review, that the dashboard then shows 'the certificate number and expiration date', the standing 8-hours-per-24-months work condition, the bar on filing without work or testing in that state in the last 24 months, the routing rule for anyone previously active in Minnesota, and the closing statement that 'If you wish to work as a nurse aide in Minnesota, you must pass the Minnesota knowledge test and skills test.'\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/docs/tutorial/interstate.pdf\"}, {\"label\": \"MDH — Nurse Aide Registry Tutorial: Searching the Registry (PDF). Establishes what a registry search returns: 'Registry status of the nurse aide; Any substantiated complaints; Dates they were active on the registry; Training and testing dates; Whether the nurse aide is a test-out candidate.'\", \"url\": \"https://www.health.state.mn.us/facilities/providers/nursingassistant/docs/tutorial/searchregistry.pdf\"}, {\"label\": \"Minnesota Nurse Aide Candidate Handbook, version 8.0, updated June 11, 2026 — the examination handbook published by MDH's test contractor and linked from MDH's Testing Information page. Establishes 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Minnesota Nurse Aide Registry', 'The Minnesota Department of Health (MDH) has approved D&S Diversified Technologies (D&SDT)-HEADMASTER to provide nurse aide testing and scoring services', the registry-maintenance description, the standing requirement to 'work at least 8 hours as a paid nursing assistant every 24 months' and that 'A 24-month lapse of employment will result in an expired registry status', 'There is no requirement to submit in-service documentation related to the Nursing Assistant Registry', that the registry does not hold background checks, the three eligibility routes to test including the expired-status route, the 24-month post-training scheduling deadline, 'You will have two hours to complete the 70-question exam', 'You must have a score of 74% or better to pass', the 12 knowledge subject areas with their question counts, the Spanish/Somali/Hmong alternate languages, the mandatory-plus-random skill task structure and the manikin tasks, and the check-in, attire and photo-ID rules.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Minnesota/forms/MN%20NA%20Candidate%20Handbook%206.11.2026.pdf\"}, {\"label\": \"D&S Diversified Technologies — Minnesota Nurse Aide (the test contractor's Minnesota page, linked from MDH as 'Minnesota Nurse Aide Testing: D&S Headmaster'). Establishes 'Headmaster is honored to be approved by the Minnesota Department of Health to offer Certified Nurse Aide Testing Services to the Minnesota Health Care Community', the two Minnesota testing platforms (MN State and In-Facility), and the current candidate handbook version and date.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Minnesota/MN_CNA_Home.htm\"}, {\"label\": \"Minn. Stat. 144A.61 (2025), Office of the Revisor of Statutes. Establishes the commissioner of health's implementing duty and contracting power, the Board of Nursing delegation that has not been used, the 'nursing assistant' definition covering nursing pool employees and excluding licensed health professionals, the competency-evaluation approval and language provisions, the mandatory interstate approval without a competency evaluation, the four-month post-hire deadline, the $300 correction-order fine, the Church of Christ, Scientist exemption and the electronic interstate filing duty.\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/144A.61\"}, {\"label\": \"Minn. Stat. 144A.611 (2025), Office of the Revisor of Statutes. Establishes the aide's reimbursement right against the nursing home or certified boarding care home for tuition, textbooks and reasonable evaluation expenses, payable '90 days after the date of employment, or upon completion of the approved training program, whichever is later', and the adult basic education reimbursement capped at 30 percent of total training and testing cost.\", \"url\": \"https://www.revisor.mn.gov/statutes/cite/144A.611\"}, {\"label\": \"42 C.F.R. 483.156 (eCFR). Establishes the federal registry frame Minnesota operates inside, including the bar on charging individuals for registration, the state's continuing accountability where operation is contracted out, the rule that only the state survey and certification agency may enter maltreatment findings, and the 24-consecutive-month removal rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR). Establishes the 75-clock-hour minimum, the 16-hour supervised practical training minimum and its definition, and the instructor qualifications MDH restates as Minnesota's own.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/mn-cna/"
  },
  {
   "page_id": "mo-cna",
   "state": "Missouri",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Missouri Department of Health and Senior Services (DHSS), Health Education Unit — the unit named in the rule as the 'Section for Long-Term Care Regulation, Health Education Unit' (19 CSR 30-84.010(8)(A)6.) and reachable at PO Box 570, Jefferson City MO 65102, cnaregistry@health.mo.gov, 573-526-5686. Testing and the day-to-day registry system are contracted out: the rule calls the contractor 'the department approved third party test administrator' (19 CSR 30-84.010(18)(B)), and DHSS names it on its own pages as Headmaster D&S. The contractor states the same scope: 'Headmaster is honored to partner with the Missouri Department of Health and Senior Services to work with and offer Certified Nurse Aide Testing and Registry Services to the Missouri Health Care Community.'",
   "board_url": "https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/certified-nurse-assistant-cna",
   "application_url": "https://mo.tmutest.com/apply",
   "renewal_cycle": "Every 24 months, on proof of eight hours of paid nursing work, for $20. The rule states the duty: 'CNAs shall submit documentation (e.g., pay stubs, W-2, letter from employer, etc.) of work in nursing or nursing related services for at least one (1) day (e.g. eight (8) hours) within each twenty-four- (24-) consecutive month period to maintain active status. Documentation shall be submitted to the department approved third party test administrator and a fee will be assessed for each renewal' (19 CSR 30-84.010(18)(B)). How it is done: sign in to the TMU account, enter the employment information, upload 'a Paystub, W2, or letter from your employer on the company letterhead', pay the $20, and the system emails the employer for verification — 'Once your employer verifies that you were working your CNA will be renewed' (DHSS). The state-linked handbook describes a self-attestation step alongside it: 'You will be self-attesting that you have worked as a CNA for at least 8 hours during the last certification period at the facility (employer) you listed. Your eligibility will be extended an additional twenty-four months.' Private-duty aides have their own route: 'Log into your profile in TMU and select private duty from the drop down menu. You will need to upload a work verification letter from the person you were caring for or their Power of Attorney. The letter will need to contain your dates of employment, a brief description of what you are helping them with, and the letter will need to be signed and notarized.' The document has to show nursing work, not just work: 'If the documentation of work hours is unrelated to nursing services, your renewal may be denied. If denied, you may be allowed 15 business days to provide the correct documentation before you will be required to pay another renewal fee.' Notices: renewal alerts go by email and text 60 days before the expiration date, and 'No renewal certifications are sent via USPS mail.' An employer-side route exists: facilities can register in the system 'as an eligible employer to verify the employment of nurse aides for the renewal of their Federal certification', and can pay renewals in bulk. A CNA can check status, update address and phone, and see the eligibility expiration date in the system at any time.",
   "ce_hours": "None for the certificate — and Missouri answers the common confusion directly. Asked whether twelve hours of in-service a year are needed to keep a CNA active, DHSS replies: 'A long-term care facility is required by state regulation to provide 12 hours of in-service to nursing personnel. If you are not employed in a long-term care facility you are not required to have the 12 hours of in-service in order to keep your certificate active.' The duty is therefore the facility's, and the aide's certificate turns on paid work rather than education: the only condition 19 CSR 30-84.010(18)(B) imposes to maintain active status is documented nursing or nursing-related work of at least eight hours in each 24-month period, plus the renewal fee. No continuing-education requirement for the individual CNA appears in 19 CSR 30-84.010 in full, on any of the DHSS CNA registry pages, or in the state-linked Missouri Nurse Aide Candidate Handbook (January 2026) — all checked. Note the contrast with a neighbouring Missouri credential DHSS runs: a Level I Medication Aide does have a renewal class — 'If you are employed as a L1MA you can check with your employer about the 4 hour renewal class' — which is a LIMA requirement, not a CNA one.",
   "exam": "Two parts — a written (or oral) knowledge exam and a practicum skills exam — and the pass standards are different for each. DHSS describes the shape: 'The two part final examination includes a written (or oral) and practicum examination.' Knowledge: 'You will have 60 minutes to complete the 75 multiple-choice questions Knowledge Exam' and 'You must have a score of 80% or better to pass the knowledge portion of the exam' — a standard the rule fixes as well ('The student shall achieve a passing score of at least eighty percent (80%)'). DHSS confirms the count in its own FAQ: 'There are 75 questions on the CNA Exam.' The published Missouri blueprint distributes those 75 as: Safety 9, Basic Nursing Skills 8, Infection Control 8, Personal Care 8, Communication 6, Disease Process 6, Mental Health 6, Aging Process and Restorative Care 5, Care Impaired 5, Resident Rights 5, Role and Responsibility 5, Data Collection 4. Language: 'In addition to English, the Knowledge Exam only is offered in the following alternate languages: Spanish.' A read-aloud audio version is available for an extra fee, and paper word-for-word translation dictionaries are allowed if they contain no writing or definitions. Skills: 30 minutes, one mandatory task first (catheter care for a female resident on a manikin; a don-PPE, empty-urinary-drainage-bag, doff-PPE sequence; perineal care for a female resident on a manikin; or perineal care for a male resident on a manikin) with hand washing embedded, then 'an additional two (2) or three (3) randomly selected tasks'. The scoring rule is strict and asymmetric: 'You must successfully complete 100% of the tasks you are assigned. You may not miss any key steps (the bolded steps) and must achieve 80% or higher on the non-key steps on each task to pass the Skill Test.' The rule states the same standard as a flat number — 'The student shall successfully complete the skills evaluation portion of the examination proctored by the department approved third party test administrator. The student shall achieve a score of one hundred percent (100%).' Steps must be performed, not described: 'Steps that are only verbalized or simulated WILL NOT COUNT.' Attempts: three, on a clock. 'Any individual who fails the final examination, except those who have been permitted to challenge the examination, shall have the opportunity to retake the examination twice within ninety (90) calendar days of the initial examination. If the individual fails the final examination a third time, the entire basic course shall be retaken before another examination can be given' (19 CSR 30-84.010). Challenge candidates get one attempt only. A payment-dispute rule worth knowing: if a card charge for testing fees is later disputed, 'the candidate would not be placed on the Registry until the disputed fee and charges are paid', and an already-listed candidate 'will be removed from the Registry until the disputed fee and charges are paid.'",
   "fees": "Missouri's published candidate costs are the exam and the renewal, and both are collected by DHSS'S contractor rather than by DHSS. Exam — DHSS publishes the split in its own FAQ: 'The CNA exam is $135.00 total. The Knowledge exam is $32.00. The skills exam is $103.00', plus 'There is an additional $10 fee for test to be read to you.' The rule authorises the charge without setting an amount: the final examination is conducted by the department approved third party test administrator 'and a fee will be assessed for each examination.' Payment is by Visa or MasterCard inside the TMU system and must be made before a test date can be scheduled; some training programs prepay for their graduates. Note that the state-linked candidate handbook carries the heading '*Price Increase Effective January 1st, 2026*' over its fee table, so a reader should treat DHSS's figures as the ones to confirm at booking. Renewal — $20.00, stated twice by DHSS ('The CNA renewal fee is $20.00') and described in the handbook as a 'non-refundable renewal fee of $20.00'. An employer may pay it instead of the aide, either by sponsoring the individual renewal or in bulk: DHSS tells employers they can 'Choose to pay for your employee's renewals in bulk' using a form obtained from the contractor. Test review — $25.00 non-refundable, to dispute a test result. No fee is published for reciprocity: the Missouri CNA Reciprocity application on the state-linked applications list shows no price, unlike several other applications on the same list. No fee is published for the challenge approval itself, which is granted by DHSS in writing, although the challenge examination is a final examination and carries the examination fee. Training can be free, and often must be: DHSS states the federal prohibition in its own words — 'No nurse assistant who is employed by, or who has an offer of employment from, a nursing facility on the date on which the assistant begins training and testing program may be charged for any portion of the program' — and adds that 'A facility is obligated by federal regulation... to reimburse on a prorated basis, a nurse aid for any training that he/she took prior to being hired, if the training took place within 12 months of hire.' Medicaid-certified nursing facilities bill the state for that training, and must wait 60 days after the final exam and bill within one year of it. One limit: 'At this time the regulations do not allow reimbursement for an individual who needs to retake the course or challenge the exam because of expired or inactive status if their original training was reimbursed.' A $100.00 application fee applies to becoming an RN Test Observer, which is a testing-staff role rather than a candidate cost.",
   "legal_basis": "[{\"citation\": \"19 CSR 30-84.010 — Nursing Assistant Training Program (Missouri Department of Health and Senior Services, Division 30, Chapter 84; Code of State Regulations edition 11/30/21)\", \"what_it_governs\": \"The entire Missouri CNA scheme: the definition of the basic course as 75 instructional hours plus 100 supervised on-the-job hours plus a final examination (1)(B); the definition of challenging the final examination (1)(D); the basic course requirements (4); the curriculum content in force since August 31, 2021 (5)(B); student enrolment, the age-18 and age-16 routes, the 'employable' definition tied to the Employee Disqualification List and the class A or B felony bar, the 16 pre-contact classroom hours, and the six-month re-enrolment right (6); the four-month rule for CNAs already hired by an ICF or SNF (7); the eight challenge categories, the reciprocity exemption from the examination, the written request contents, the 120-day life of a challenge permission letter, and the one-attempt rule (8); training agency responsibilities and examiner requirements (9) onward; the two testing procedures, the 80% knowledge and 100% skills standards, the three-tests-at-80% coursework gate, and the two retakes within 90 days (testing provisions); and the CNA Registry section — placement on passing, the eight hours of documented nursing work every 24 months submitted to the department approved third party test administrator with a fee, the challenge route for aides inactive under five years, and the full-course requirement for those inactive over five years (18).\", \"url\": \"https://s1.sos.mo.gov/cmsimages/adrules/csr/current/19csr/19c30-84.pdf\"}, {\"citation\": \"Section 198.082, RSMo (Nursing assistant training programs — training incomplete, special requirements and supervision for assistant beginning duties), part of the Omnibus Nursing Home Act\", \"what_it_governs\": \"The statutory mandate behind the training program. The rule's own purpose clause states it: 'The Omnibus Nursing Home Act mandates in section 198.082, RSMo, that nursing assistants employed in skilled nursing and intermediate care facilities complete an approved training program', and DHSS repeats that 'The certified nurse assistant (CNA) training program is required by the Omnibus Nursing Home Act and Section 198.082, RSMo, 1994.' The section's own text could not be read as of August 16, 2026 — the Missouri Revisor of Statutes site did not respond — so nothing here is quoted from it; it is listed because Missouri's own rule and agency name it as the authority.\", \"url\": \"https://revisor.mo.gov/main/OneSection.aspx?section=198.082\"}, {\"citation\": \"Section 198.006, RSMo (Definitions) and section 192.2495.1, RSMo (criminal background checks of employees)\", \"what_it_governs\": \"The definitions used across the long-term care chapter, and the criminal background check regime for facility employees including the hiring restrictions and the process for waiving them. DHSS lists both on its own Laws, Regulations and Manuals page as the laws governing this program. Their texts could not be read as of August 16, 2026, for the same reason as above, and nothing here is quoted from them.\", \"url\": \"https://revisor.mo.gov/main/ViewChapter.aspx?chapter=198\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal floor Missouri exceeds: a minimum of 75 clock hours of training with at least 16 hours of supervised practical training. DHSS cites this section by name when defining active status ('has met all the requirements for training and testing in Federal regulation 483.152 and State regulation 19 CSR 30-84.010') and lists it among the federal regulations governing the program. Missouri's 175-hour basic course sits well above it.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"42 C.F.R. 483.156 (Registry of nurse aides)\", \"what_it_governs\": \"The federal registry frame: the state's duty to establish and maintain the registry, the permission to contract its daily operation to a non-state entity while retaining accountability, the bar on charging individuals for registration itself, the reservation of abuse, neglect and misappropriation findings to the state survey and certification agency, and the removal of entries after 24 consecutive months without nursing or nursing-related services — the rule behind Missouri's 24-month renewal requirement. DHSS lists this section among the federal regulations governing the program.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}]",
   "exam_vendor": "D&S Diversified Technologies (D&SDT)-Headmaster, under contract to DHSS — the entity the Missouri rule calls 'the department approved third party test administrator' and DHSS's own site menu calls 'Headmaster D&S'. The handbook states the appointment, and prints the agency's name short: 'The Missouri Department of Health (DHSS) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide tests and scoring services for nurse aide testing' — the full name is the Department of Health and Senior Services, which is what the handbook's own 'DHSS' abbreviates. The contractor describes its Missouri scope as 'Testing, Certification and Registry Services'. Missouri does not use the NNAAP — the instrument is the Missouri Nurse Aide Competency Exam, delivered electronically in the contractor's TMU system, with the knowledge portion proctored by a Knowledge Test Proctor and the skills portion observed by an RN Test Observer. The rule still describes an older, examiner-run route, and both texts are in force on paper: 19 CSR 30-84.010 sets out one testing procedure for agencies teaching the 2001-manual curriculum, in which 'the final examination shall be conducted by an approved examiner who may be assisted by the instructor' and the student completes at least nine procedures under observation; and a second for agencies teaching the current curriculum, in which 'The final examination shall be conducted by the department approved third party test administrator and a fee will be assessed for each examination.' Since all training agencies were required to transition to the current curriculum by August 31, 2021, the third-party route is the operative one, and it is the only one DHSS describes to candidates today. Test sites are booked through the contractor, with DHSS advising facilities to 'Schedule your test site 14 days in advance.'",
   "training_hours": "175 hours total — 75 classroom plus 100 supervised on-the-job — and Missouri is one of the highest-hour states in the country because of it. The figure is in the rule's own definition: 'Basic course—means the seventy-five (75) hours of instructional training, the one hundred (100) hours of supervised on-the-job training, and the final examination of the nursing assistant training course' (19 CSR 30-84.010(1)(B)). The requirements section repeats it as the program minimum: a program 'shall consist of a basic course that includes, at a minimum... (A) Seventy-five (75) hours of instructional training in the curricula identified in section (5) of this rule; (B) One hundred (100) hours of supervised on-the-job training (clinical practice) in an approved laboratory or other setting in which the student demonstrates knowledge while performing tasks on an individual under the supervision of a LPN or RN; and (C) A final examination' ((4)). DHSS states the same total in plain language on its CNA page — 'The state approved course requires the individual to complete 75 hours of classroom training, 100 hours of on-the-job training and successfully complete a two part final examination' — and in its FAQ: 'The CNA program consist of a minimum of 75 Classroom Hours and 100 Clinical Hours.' Missouri also uses the 175 figure as its yardstick when judging other training: an applicant relying on Unlicensed Assistive Personnel training is told 'this program's training hours should mirror the CNA training. The CNA training consists of 175 total training hours.' How the 100 clinical hours are subdivided in practice: Missouri's own Classroom and On-the-Job Training Record form breaks them into an 84-hour on-the-job block and a 16-hour competency-evaluation block, each signed off separately by a charge nurse and a clinical supervisor. The first 16 classroom hours are fenced: sixteen of the seventy-five instructional hours, covering communication and interpersonal skills, infection control, safety and emergency procedures including the Heimlich maneuver, promoting residents' independence and respecting residents' rights, must be finished before a student in a Medicare- or Medicaid-certified facility has any direct contact with a resident ((6)(B)). Curriculum: since August 31, 2021 all approved training agencies teach the content set out at 19 CSR 30-84.010(5)(B)1., an eleven-area syllabus running from infection control and personal care skills to care of cognitively impaired residents and residents' rights, using 'current published instruction material(s) that are no more than ten (10) years old.' Class size: DHSS publishes no cap on the classroom portion — 'There is no ration limit for the 75 hour classroom portion of the program' — but during clinical hours 'the maximum ratio is one (1) to fifteen (15) and it is recommended that the ratio be one (1) to ten (10) or less.'",
   "lapse_rule": "Missouri has three statuses and two different clocks, and the difference decides whether you test or retrain. DHSS defines them: Active means all training and testing requirements are met and 'This individual is eligible to be employed as a CNA in a long-term care facility if there has been no finding of abuse, neglect or misappropriation of property.' Inactive — 'Your CNA certificate is considered inactive if the registry shows a two (2) year break in employment in the provision of nursing services.' Expired — 'Missouri Registry Expired CNA Status means that the DHSS records show the CNA did not perform nursing services in five (5) consecutive years. The CNA cannot work as a Certified Nurse Assistant in a Long-Term Care (LTC) facility when listed as Expired.' How to get back, in the rule's own terms: if you have the work documentation, you simply renew — DHSS says an inactive CNA 'may change your status from inactive to active if you completed and can provide proof of nursing related services', for the $20 fee, and says the same for expired status. If you do not have it, the five-year line decides: 'A CNA who has been inactive on the registry for less than five (5) years and cannot provide documentation... shall challenge the final examination in accordance with section (8) of this rule before the CNA is reinstated to the active registry' (19 CSR 30-84.010(18)(C)); and 'A CNA who has been inactive on the registry for more than five (5) years and cannot provide documentation... is not eligible to challenge the final examination and shall successfully complete the entire basic course before the CNA is reinstated to the active registry' ((18)(D)). DHSS's FAQ says the same in shorter words: 'If your certificate is inactive you may challenge the examination to obtain active status. If your certificate is expired you may be required to retake the course to obtain active status.' And the challenge is a single attempt: 'If you Challenge the CNA and Fail the exam you will have to take the full CNA course in Missouri.' The lapse cascades to the CNA's other Missouri credentials — an inactive or expired CNA makes any Certified Medication Technician or Insulin Administration certificate inactive or expired too, and both revive when active CNA status is regained. A separate, permanent kind of lapse is the federal indicator: a finding of abuse or misappropriation cannot be removed at all, and a single occurrence of neglect can be petitioned in writing to the DHSS Office of General Counsel.",
   "reciprocity": "Missouri grants reciprocity and exempts the applicant from the Missouri exam, and the rule says so in a single sentence: 'Individuals who are certified and active on another state's nurse aide registry shall not be required to challenge the final examination' (19 CSR 30-84.010(8)(B)). DHSS repeats it for readers: 'If you are coming to MO, reciprocity allows you to become a CNA without taking the Missouri CNA exam. CNA that has been certified in another state, is in good standing and would like to become a CNA in Missouri. Reciprocity allows you to do so, without taking the Missouri CNA exam.' What the rule requires you to send: 'The individual shall submit, in writing to the department, a request to be added to the Missouri Certified Nurse Assistant Registry. At a minimum, the request shall include: the individual's legal name; Social Security number; current address; telephone number; email address, if applicable; and proof of their current certified nursing assistant certificate. The department will respond in writing, either approving or denying the request to be added to the registry.' How it is actually filed now: through an online application rather than by post or email — 'Complete the Missouri Reciprocity form. You will need to upload your documents that verifies your CNA certification in another state... Do not submit reciprocity documents by email, unless prior arrangements have been made with one of our representatives.' DHSS decides, not the contractor: 'Once DHSS has received your completed application and all required documentation, they will determine if you are eligible to be added to the Missouri Certified Nurse Aide Registry.' Afterwards: 'Once you have been approved, you may log into TMU and print off your Missouri CNA certificate.' No fee is shown for the reciprocity application on the state-linked applications list. One state-specific condition is published: 'ALABAMA APPLICANTS: If you originally trained in Alabama more than two years ago and are only certified in Alabama, you must also include employment verification.' Transferring out is the part people get stuck on, and Missouri is blunt about it: 'You will need to contact each state that you want to be certificated in to ask about their regulations regarding reciprocity as each state is different. The Missouri Registry Team will not fill out reciprocity verification forms for other states.' Missouri's answer to an out-of-state verification request is to point at the public registry search instead. Two housekeeping notes: 'Do not submit your request twice. Submitting your documents twice only slows down the process', and a CNA lapsed in another state is not a reciprocity case at all.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Missouri Department of Health and Senior Services — Certified Nurse Assistant (CNA). The program's landing page. Establishes 'The certified nurse assistant (CNA) training program is required by the Omnibus Nursing Home Act and Section 198.082, RSMo, 1994'; 'The state approved course requires the individual to complete 75 hours of classroom training, 100 hours of on-the-job training and successfully complete a two part final examination. The two part final examination includes a written (or oral) and practicum examination'; the DHSS Health Education Unit contact details; and the links to the registry search, the renewal instructions and the approved training agency datasets.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/certified-nurse-assistant-cna\"}, {\"label\": \"DHSS — CNA Status. Establishes the three registry statuses in DHSS's own words: Active ('has met all the requirements for training and testing in Federal regulation 483.152 and State regulation 19 CSR 30-84.010'), Inactive (changeable on proof of nursing-related services, with 'The CNA renewal fee is $20.00'), and Expired ('the CNA did not perform nursing services in five (5) consecutive years... The CNA cannot work as a Certified Nurse Assistant in a Long-Term Care (LTC) facility when listed as Expired'); the cascade to CMT and Insulin Administration certificates; the Federal Indicator regime including the neglect-only removal route and the prohibition on employing or allowing to volunteer anyone carrying one; and the employer's duty to seek registry verification from all states.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/cna-status\"}, {\"label\": \"DHSS — Frequently Asked Questions (CNA, CMT, LIMA & Insulin Registry). Establishes the inactive/expired definitions as two-year and five-year breaks; the renewal mechanics including the $20 payment, the paystub/W2/letterhead documentation, the employer verification email, and the notarised letter route for private-duty aides; the employer bulk-renewal option; the age-18 enrolment rule with the high-school vo-tech exception; the EDL and felony bars and the good cause waiver contact; 'The CNA program consist of a minimum of 75 Classroom Hours and 100 Clinical Hours'; the 120-day certification deadline for facility hires; the one-year window from course start to test; the six-month re-entry right; the exam prices ('The CNA exam is $135.00 total. The Knowledge exam is $32.00. The skills exam is $103.00') and the $10 read-aloud fee; 'There are 75 questions on the CNA Exam'; the reciprocity-in answer and the refusal to complete other states' verification forms; the name-change procedure; the in-service answer ('If you are not employed in a long-term care facility you are not required to have the 12 hours of in-service in order to keep your certificate active'); and the instructor, clinical supervisor and CMT qualification lists.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/frequently-asked-questions\"}, {\"label\": \"DHSS — What is Reciprocity in Missouri. Establishes 'Reciprocity allows you to become a CNA without taking the Missouri CNA exam'; the online application route and the instruction 'Do not submit reciprocity documents by email, unless prior arrangements have been made'; the review order; and 'Once you have been approved, you may log into TMU and print off your Missouri CNA certificate.'\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/what-reciprocity-missouri\"}, {\"label\": \"DHSS — CNA Challenge. Establishes that challenge approval means 'individuals who meet special criteria... are not required to take the entire certified nurse assistant course but rather will be allowed to successfully complete exam with \\\"one attempt\\\"'; the documents a written challenge request must contain; and the qualifying categories including the four-month nursing-program route, the failed-licensure-examination route, the foreign-graduate route, the UAP route with its statement that 'The CNA training consists of 175 total training hours', the inactive-registry route, and the residual gerontology/health-occupations route.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/cna-challenge\"}, {\"label\": \"DHSS — Training Agencies. Establishes which organisations may sponsor an approved CNA training program (vocational-technical school, comprehensive high school health services program, community college, approved private schools, hospital, licensed nursing home, Missouri Veterans Home), the approval requirements including classroom space for fifteen students and an on-site evaluation every approval period, and the two-year approval period with reapplication thirty days before expiry.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/training-agencies\"}, {\"label\": \"DHSS — Laws, Regulations & Manuals. Establishes the authorities DHSS itself names for this program: sections 198.006, 198.082 and 192.2495.1, RSMo; 19 CSR 30-84.010 (Nurse Assistant Training Program), 30-84.020 (CMT), 30-84.030 (LIMA), 30-84.040 (Insulin Administration) and 30-85.042; and 42 CFR 483.75, 483.150, 483.151, 483.152, 483.154, 483.156 and 483.158.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/laws-regulations-manuals\"}, {\"label\": \"DHSS — Headmaster D&S. Establishes DHSS's own naming of its contractor, the link to the contractor's Missouri site, the Missouri Mock Skills document, and the operational instruction to facilities to 'Schedule your test site 14 days in advance' and submit the test request form at least 14 days before a testing event.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/headmaster-ds\"}, {\"label\": \"DHSS — Certified Nurse Assistant Reimbursement. Establishes the Medicaid reimbursement scheme for nurse assistant training under OBRA '87, the prohibition on charging an employed or offered aide for any portion of the program, the facility's obligation to reimburse pro rata for training taken within 12 months before hire, the 60-day wait and one-year billing deadline, and the exclusion of reimbursement for retaking or challenging because of expired or inactive status where the original training was reimbursed.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/certified-nurse-assistant-reimbursement\"}, {\"label\": \"DHSS — Paid Feeding Assistant. Establishes that 'The paid feeding assistant does not have to be a certified nurse assistant', the federal 8-hour minimum training and its eight required topics, the facility record-keeping duty, and that a licensed registered nurse must teach the course.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/paid-feeding-assistant\"}, {\"label\": \"DHSS — Certified Nurse Assistant (CNA) Forms. Establishes the state forms in use: the Classroom and On-the-Job Training Record, the Application for Approval as a Nursing Assistant Training Agency, and the CMT training agency application.\", \"url\": \"https://health.mo.gov/providers/cna-cmt-lima-insulin-registry/certified-nurse-assistant-cna-forms\"}, {\"label\": \"19 CSR 30-84 (Training Program for Nursing Assistants), Missouri Secretary of State, Code of State Regulations, edition 11/30/21. The controlling rule text — establishes the 75/100/final-examination definition of the basic course, the enrolment and 'employable' rules, the 16 pre-contact hours, the four-month facility rule, the challenge categories and their one-attempt limit and 120-day permission window, the reciprocity exemption from examination, the 80% knowledge and 100% skills standards, the three-tests-at-80% coursework gate, the two retakes within 90 days, and the CNA Registry section with the 24-month, eight-hour documentation duty and the under-five-year challenge / over-five-year full-course split. Also carries the Certified Nurse Assistant Competency Score Sheet with its nine practicum procedures and the federal-marker warning the student must initial.\", \"url\": \"https://s1.sos.mo.gov/cmsimages/adrules/csr/current/19csr/19c30-84.pdf\"}, {\"label\": \"Missouri Nurse Aide Candidate Handbook, January 2026 — the examination and registry handbook published by DHSS's contractor and linked from DHSS's own pages. Establishes the MOCNAR description including the EDL and Federal Indicator flags; 'A newly trained nurse aide candidate must pass both the knowledge and skills exams within one (1) year of the training start date'; the 24-month renewal rule with eight consecutive paid hours, the self-attestation step, the 15-business-day cure period for wrong documentation, and the non-refundable $20.00 renewal fee; the 60-day email and text renewal notice and that nothing is mailed; the reciprocity application route and DHSS's role in deciding it; the challenge one-attempt rule; the '*Price Increase Effective January 1st, 2026*' heading over the fee table; the card-dispute rule that removes a candidate from the registry; the knowledge exam format (75 multiple-choice questions in 60 minutes, 80% to pass) with its twelve-area blueprint; Spanish as the only alternate language; the translation-dictionary, scratch-paper and calculator rules; the 30-minute skills test with one mandatory hand-washing task plus two or three random tasks; and the skills scoring rule that no key step may be missed and non-key steps must reach 80%.\", \"url\": \"https://hdmaster.com/testing/cnatesting/missouri/forms/MO%20NA%20Candidate%20Handbook%201.2026.pdf\"}, {\"label\": \"D&S Diversified Technologies — Missouri Nurse Aide (the contractor's Missouri page, linked from DHSS as 'Headmaster D & S Website'). Establishes 'Headmaster is honored to partner with the Missouri Department of Health and Senior Services to work with and offer Certified Nurse Aide Testing and Registry Services to the Missouri Health Care Community', the candidate handbook version (January 2026), the mock skills effective for testing from September 1, 2025, and the candidate and training-program document set.\", \"url\": \"https://hdmaster.com/testing/cnatesting/missouri/MO_CNA_Home.htm\"}, {\"label\": \"Missouri TMU — Account Applications (the applications list DHSS links for reciprocity, challenge, renewal exceptions and testing roles). Establishes the Missouri CNA Reciprocity application with no fee shown and its Alabama-specific condition; the CNA Challenge application; the Inactive/Expired CNA License Renewal application, which asks for proof of eight hours of nursing-services work and points aides who went inactive within the last 24 months to renew from their own account instead; the Request for Testing Extension for candidates whose training has expired; the employer registration application; the $25.00 Test Review Request; and the $100.00 RN Test Observer / TASE application.\", \"url\": \"https://mo.tmutest.com/apply\"}, {\"label\": \"Missouri TMU — Public registry search. Establishes the four search modes offered (Name, SSN, Registration Number, Misconduct) and the 'Download Misconduct List' option.\", \"url\": \"https://mo.tmutest.com/search\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR). Establishes the 75-clock-hour and 16-supervised-practical-hour federal minimums that Missouri's 175-hour course exceeds, and the instructor qualifications underlying Missouri's RN instructor rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"label\": \"42 C.F.R. 483.156 (eCFR). Establishes the federal registry frame Missouri operates inside, including the permission to contract daily registry operation to a non-state entity while retaining state accountability, the bar on charging individuals for registration, and the 24-consecutive-month removal rule behind Missouri's renewal requirement.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}]",
   "page_url": "https://licensingatlas.com/cna/mo-cna/"
  },
  {
   "page_id": "ms-cna",
   "state": "Mississippi",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Mississippi State Department of Health (MSDH), Bureau of Health Facilities Licensure and Certification — the agency its own rules call 'the licensing agency': 'Licensing Agency. Shall mean the Division of Licensure and Certification of the Mississippi Department of Health, which is the Mississippi Survey Agency' (Miss. Admin. Code Title 15, Part 3, Rule 54.3.16). Both the testing and the registry are contracted out, and MSDH says so in one sentence: 'Our CNA registry is managed by Headmaster/TMU.' The contractor states the same scope: 'D&SDT-Headmaster is honored to be approved by the Mississippi Department of Health to offer Certified Nurse Aide Testing and Registry Services to the Mississippi Health Care Community.'",
   "board_url": "https://msdh.ms.gov/page/30,0,83,74.html",
   "application_url": "https://ms.tmutest.com/apply",
   "renewal_cycle": "Every twenty-four months, and your employer has to confirm it. The state-linked handbook states the rule and the qualifying work in one paragraph: 'To maintain eligibility to work, you must renew your eligibility every twenty-four months. To be eligible to renew, you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous twenty-four months. Nurse aides with misconduct restrictions on the Registry are not eligible for renewal. You are allowed 30 days after your certification expires to renew. If your license has been expired over 30 days, you will need to test to recertify.' How it works: 'To renew, sign in to your TMU© account at ms.tmutest.com and list your work hours and where you were employed (nursing home, hospital, hospice, home health agency, or ICF/MR facility). An email verification link will be sent to the employer contact you choose from the list of employers. When the employer verifies your work experience, your eligibility will be extended an additional twenty-four months.' Agency staff have a specific instruction: 'If you are working for an employment agency, you must have the long-term care facility where you are placed listed as your employer... Employment agencies are not listed in the list of employers and cannot verify your employment.' Work that does not count, listed by Mississippi itself: 'Employment as a private-duty aide, doctor's office aide, laboratory aide, personal care home assisted living aide, or personal care home residential living aide does not qualify for recertification.' If you are not currently working as an aide, 'you will choose your last nurse aide employer from the list of employers.' A non-employer route exists for out-of-state work or a defunct employer, filed as its own $25 application. Military extension: 'Any person in the armed services of the United States holding a valid nurse aide certificate and who is out-of-state due to military service at the time their nurse aide certification expires may renew at any time within 120 days after being honorably discharged from such military service or upon returning to the State, without payment of any delinquent fees, retraining, and/or re-examination,' on production of a military ID (front and back) and orders — with the caution that this 'does not allow individuals with expired certification to work as certified nursing assistants in long-term care facilities that participate in Medicaid and Medicare.' Notice: renewal alerts go by email and text 60 days before expiry, and nothing is mailed.",
   "ce_hours": "None. Mississippi conditions continued registry eligibility on paid nurse aide work and on employer verification of it, not on continuing education: the handbook's renewal rule is 'you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous twenty-four months', and the renewal transaction consists of listing work hours and having the employer confirm them. No continuing-education, in-service or refresher requirement for the aide appears anywhere in the Mississippi Nurse Aide Candidate Handbook (version 3.0, January 2026), on MSDH's CNA (Nurse Aide) Certification and Training page, on MSDH's Nurse Aide Training Courses page, in Miss. Admin. Code Title 15, Part 3, Chapter 54 (Minimum Standards for Certified Nurse Aides), in Chapter 45 (Minimum Standards for Institutions for the Aged or Infirm), or on the Mississippi TMU applications list — all checked. Note the distinction that catches people out in every state: federal law puts an in-service training duty on the facility, not on the aide, and nothing in Mississippi's published nurse aide material converts that into a personal renewal condition.",
   "exam": "Two parts, both required: 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Mississippi Nurse Aide Registry.' Knowledge test — 'The Knowledge Test consists of 70 multiple-choice questions', 'You will have 60 minutes to complete the exam', and 'You must have a score of 73% or better to pass the knowledge portion of the exam.' The candidate is told when fifteen minutes remain and may not ask what a question means. The published Mississippi blueprint distributes those 70 questions as: Basic Nursing Skills 11, Infection Control 10, Safety 9, Communication 6, Disease Process 5, Personal Care 5, Resident Rights 5, Role and Responsibility 5, Data Collection 4, Mental Health 4, Aging Process and Restorative Care 3, Care Impaired 3. An audio version exists and costs extra: 'An audio (oral) version of the knowledge exam is available. However, there is an extra $10 charge for the audio version ($45 total), and you must request an Audio version before you submit your testing fee payment' — questions are heard through wired headphones or earbuds, and 'Bluetooth-connected devices are not allowed.' A remotely proctored knowledge exam is also offered, taken from home on a personal computer with Google Chrome and a reliable connection. Skill test — the first task is always drawn from a fixed mandatory set with hand washing built in (assisting with a bedpan and measuring urine output; catheter care for a female resident on a manikin; a don-PPE, empty-urinary-drainage-bag, doff-PPE sequence; or perineal care for a female resident on a manikin), and 'You will also receive an additional two (2) or three (3) randomly selected tasks from the Skill Task listing,' each with a scenario read aloud by the RN Test Observer. Failing the skill test does not change the structure: 'If you fail the Skill Test, there will always be one of the first mandatory tasks to start each Skill Test.' Results — next business day, after 7:00PM central, and only online. The Mississippi candidate handbook (version dated January 2026) states the state's own rule: 'After you have completed both the Knowledge Exam and Skill Test components of the competency exam, your test results will be officially scored and double-checked by D&SDT-HEADMASTER scoring teams. Official test results will be available after 7:00PM (CT) on the business day after your test event by signing in to your TMU© account. D&SDT-HEADMASTER cannot release test results over the phone.' Two things follow that catch people out: 'D&SDT-HEADMASTER does not send postal mail test results letters', and 'Sign in to your TMU© account at ms.tmutest.com to view your test results.' Ignore any paper-test timeline you see on the contractor's general pages — they cover several states, and Mississippi is not one of the paper ones: 'All test sites in Mississippi utilize electronic TMU© testing using Internet-connected computers.' A three-to-five-business-day paper turnaround cannot happen here. A candidate can challenge a result, for a deposit: 'There is a $25 non-refundable test review deposit fee'; if the review goes the candidate's way the deposit is refunded, and if not 'the $25 test review deposit will stand, and the fee is non-refundable.' Test-day basics: full clinical attire (scrubs) with no open-toed shoes, and photo ID re-presented at both the knowledge room and the skills lab if testing on the same day.",
   "fees": "MSDH publishes no state application or listing fee — every published dollar figure in Mississippi's nurse aide system is charged by MSDH's contractor inside the TMU system, and the federal rule bars charging for the registration itself: 'The State may not impose any charges related to registration on individuals listed in the registry' (42 C.F.R. 483.156(b)(4)). Examination fees, from the state-linked candidate handbook's payment table: knowledge exam $35.00, skill exam $100.00, both together $135.00 — and the same figures apply to a retake of either component. The audio version of the knowledge exam adds $10 ($45 total). Payment is by Visa or MasterCard credit or debit card inside TMU, and 'Testing fees must be paid before you can schedule a test date.' Other published charges, from the applications list on the Mississippi TMU system and the handbook: CNA Reciprocity Form $25.00, described in the handbook as a 'processing administrative assessment fee of $25'; Non-Employer Renewal $25.00, the route used 'for out-of-state work or if your employer no longer exists to qualify for renewal on the Mississippi nurse aide registry'; Out-of-State Certification Reactivation by Examination $25.00; Test Review Request $25.00, non-refundable unless the review finds in your favour; and a $35 refund processing fee deducted from any refund of testing fees paid. A separate $100.00 application fee applies to becoming an RN Test Observer / Test Administration Services Entity, which is a testing-staff role rather than a candidate cost. What is not published: MSDH does not publish tuition for approved training programs, and the ordinary employer-verified registry renewal shows no fee on the applications list.",
   "legal_basis": "[{\"citation\": \"Miss. Admin. Code Title 15, Part 3, Chapter 54 — Minimum Standards for Certified Nurse Aides (Mississippi State Department of Health, Office of Health Protection, Health Facilities Licensure and Certification; revised October 2012)\", \"what_it_governs\": \"The registry's enforcement half: the rule that only the licensing agency may flag or place adverse findings on the Nurse Aide Registry (54.1.1); the definitions of abuse, neglect, exploitation, involuntary seclusion, misappropriation, 'aide', 'licensing agency' and 'long-term care resident' (54.3); the investigation and ten-working-day notification procedure (54.4); the administrative hearing — appointment of a hearing officer, the 120-day completion deadline, the substantial-evidence standard, the sixty-day written decision as final agency action, and the notice stating ineligibility to work in a Mississippi long-term care facility and the right to appeal to chancery court (54.5); reporting findings to the registry within ten working days, their permanent retention, the effect of a criminal conviction or nolo plea, and restoration of the aide's name if the finding is not upheld (54.6); and confidentiality of records (54.7). Each rule cites Miss. Code Ann. 43-11-13 as its source, and Rule 54.2.1 states that hearings are held pursuant to 42 C.F.R. 483.156(a) and 483.158(c).\", \"url\": \"https://msdh.ms.gov/page/resources/1757.pdf\"}, {\"citation\": \"Miss. Code Ann. 43-11-13 (cited as the source of authority throughout Chapter 54)\", \"what_it_governs\": \"The statutory authority under which MSDH adopts the nurse aide rules and operates the registry. Every rule in Chapter 54 carries the line 'SOURCE: Miss. Code Ann. 43-11-13'. The section's own text was not read as of August 16, 2026; nothing on this page is quoted from it, and it is listed here because Mississippi's own regulation names it as the authority.\", \"url\": \"https://msdh.ms.gov/page/resources/1757.pdf\"}, {\"citation\": \"42 C.F.R. 483.156 (Registry of nurse aides)\", \"what_it_governs\": \"The federal frame Mississippi's registry sits inside, and the provision that explains why a contractor can run it: 'The State may contract the daily operation and maintenance of the registry to a non-State entity. However, the State must maintain accountability for overall operation of the registry and compliance with these regulations,' together with the rule that 'Only the State survey and certification agency may place on the registry findings of abuse, neglect, or misappropriation of property', the bar on charging individuals for registration, the removal of entries after 24 consecutive months without nursing or nursing-related services, and the permanent retention of maltreatment findings. Mississippi's Rule 54.2.1 cites this section by name.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}, {\"citation\": \"42 C.F.R. 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The training floor that applies in Mississippi in the absence of a published state hour figure: a program must 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training', with supervised practical training defined as training in which the trainee performs tasks on an individual under the direct supervision of a registered nurse or licensed practical nurse.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"Miss. Admin. Code Title 15, Part 3, Chapter 45 — Minimum Standards for Institutions for the Aged or Infirm (nursing homes), adopted under Miss. Code Ann. 43-11-1 through 43-11-17\", \"what_it_governs\": \"Nursing home licensure standards generally. It is listed here for a negative reason a reader can check: its full text contains no nurse aide training, hour or registry provision, which is part of why no Mississippi-published training-hour figure appears on this page.\", \"url\": \"https://msdh.ms.gov/page/resources/119.pdf\"}]",
   "exam_vendor": "D&S Diversified Technologies, LLP (D&SDT)-Headmaster, LLP, under contract to MSDH: 'The Mississippi Department of Health (MSDH) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide tests and scoring services for nurse aide testing.' The same contractor also runs the registry — 'Certified Nurse Aide Testing and Registry Services' — and everything a candidate does (paying, scheduling, renewing, applying for a waiver or reciprocity, checking status) happens in the contractor's TestMaster Universe (TMU) system at ms.tmutest.com. A conflict about what the exam is called, recorded both ways and not resolved: MSDH's own CNA page says 'Upon completion of the program, you are required to take the National Nurse Aide Assessment Program (NNAAP) exam' and, further down, describes registered nurses 'functioning as Evaluators for the NNAAP Skills exam' — but the current state-linked handbook, published by the contractor MSDH names on that same page, is titled the Mississippi Nurse Aide Candidate Handbook and calls the test 'THE MISSISSIPPI NURSE AIDE COMPETENCY EXAM', with items 'selected from subject areas in accordance with the Mississippi State Department of Health-approved Mississippi test plan.' The NNAAP is a differently-branded national program; the handbook never uses that name. MSDH's page carries a 'Last reviewed on Aug 14, 2024' stamp and the handbook is dated January 2026, so the likeliest reading is that the MSDH page is out of date — but both are official Mississippi sources, so both are reported here rather than one being silently preferred. Anyone booking a test should expect the Mississippi exam described in the handbook.",
   "training_hours": "Mississippi publishes no state-specific hour figure that could be found, and this page will not invent one. What MSDH publishes is the requirement to attend an approved program at all — 'To become a Certified Nurse Aide (CNA) you will need to enroll in a Mississippi state-approved nurse aide training program (NATP)' — together with a county-by-county list of approved programs. No total, no classroom/clinical split, and no minimum clock-hour count appears in any Mississippi source we checked. The sources checked: MSDH's CNA (Nurse Aide) Certification and Training page; MSDH's Nurse Aide Training Courses page; MSDH's Feeding Assistants page; the MSDH list of approved Nurse Aide Training Programs in Mississippi; MSDH's own Health Facilities regulations index and the two regulations on it that could carry the rule — 'Minimum Standards for Certified Nurse Aides' (Miss. Admin. Code Title 15, Part 3, Chapter 54), which turns out to govern only the abuse/neglect investigation and hearing process, and 'Minimum Standards for Institutions for the Aged or Infirm' (Chapter 45), whose full text contains no nurse aide training provision at all; the Mississippi Nurse Aide Candidate Handbook (version 3.0, January 2026) in full; and the Mississippi TMU public pages including the applications list and FAQ. What governs instead is the federal floor. Every state's nurse aide program must, at a minimum, 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training' (42 C.F.R. 483.152(a)(1), (a)(3)), and Mississippi's own reciprocity rule points at that federal frame as the standard it recognises — an out-of-state aide qualifies only if entered on that state's registry 'in accordance with the training and competency evaluation requirements of OBRA '87, as amended.' A reader should treat 75 hours as the floor a Mississippi program cannot go below, and ask the specific program for its actual hour count, because Mississippi does not publish one. The one place hours surface in Mississippi's own system is administrative rather than regulatory: the training program records the candidate's 'completion hours and date' in the contractor's software before the candidate becomes eligible to schedule a test — so hours are captured per candidate, but no published minimum was located.",
   "lapse_rule": "Thirty days of grace, then you test again — and you get one shot. 'You are allowed 30 days after your certification expires to renew. If your license has been expired over 30 days, you will need to test to recertify' (state-linked candidate handbook). The underlying trigger is the federal 24-month work rule, which the handbook states plainly: 'Under federal regulations, a nurse aide becomes ineligible for employment if they do not perform at least 8 hours of nursing-related services for pay in a health care setting during a period of twenty-four consecutive months. To re-establish employment eligibility on the MSNAR, you must successfully pass both components of the approved Mississippi nurse aide competency examination.' The one-attempt rule is the harshest detail in Mississippi's scheme and it is easy to miss: 'LAPSED NURSE AIDE: You are only allowed one attempt to pass the Mississippi competency exam. If you fail either component (either the knowledge or the skills exam) on your first try, you will be required to complete a Mississippi Department of Health (MSDH)-approved nurse aide training program before being allowed to re-test as a new nurse aide.' The same single-attempt limit applies to the out-of-state reactivation route. Re-entry is filed as a Reactivation by Examination application in the TMU system, or the Out-of-State Certification variant for a lapsed or soon-to-lapse credential from another state. A different kind of lapse — a misconduct restriction — cannot be renewed away at all: 'Nurse aides with misconduct restrictions on the Registry are not eligible for renewal.' A neglect finding, but not abuse or misappropriation, can be petitioned off after a year: 'An individual with a finding of neglect placed on the nurse aide registry listing after January 1, 1995, may petition the Mississippi State Department of Health (MSDH), Bureau of Health Facilities Licensure and Certification (HFLC), for removal of the finding of neglect from their name one (1) full year after the finding is placed on the MS Nurse Aide Registry.' The petition covers 'a single entry of Neglect', must use MSDH's standard format, and 'will be reviewed, and the nurse aide will be notified in writing of a final decision within 45 days of completing the petition'; the handbook is careful that this 'should in no way be construed as a formal evidentiary hearing process.'",
   "reciprocity": "Mississippi calls it reciprocity, treats it as an application, and charges $25. MSDH's own eligibility statement: 'Reciprocity allows a certified nurse aide from another state to qualify for certification in the state of Mississippi. An individual is only eligible for reciprocity if he or she has been entered on a nurse aide registry in a state other than Mississippi in accordance with the training and competency evaluation requirements of OBRA '87, as amended, and if the individual is currently listed on that state's nurse aide registry as active and in good standing.' The handbook adds the mechanics: 'In any case, you must be current and in good standing on a nurse aide registry in a state other than Mississippi to be considered. To apply for reciprocity placement on the MSNAR, you must complete a CNA Reciprocity Form Application in the Mississippi TMU©... Once your completed application, reciprocity verification, processing administrative assessment fee of $25, and all required documentation have been received, D&SDT-HEADMASTER staff will determine if you are eligible to be added to the Mississippi Nurse Aide Registry.' Note who decides: the eligibility determination is made by MSDH's contractor, not by MSDH. No examination is required on this route — a current, good-standing out-of-state aide transfers in. What is not reciprocity, and the distinction costs money: if the out-of-state certification has lapsed, or is current but cannot be renewed for want of work history and expires within 60 days, the route is not reciprocity but 'OUT OF STATE CERTIFICATION - Reactivation by Examination' — an exam route, also $25, and capped at a single attempt before full retraining is required. Warning about the paperwork: 'Failure to provide complete and accurate information during the reciprocity determination process may delay or even prevent you from being listed on the MSNAR.' Separately, a Mississippi aide who is on the MSNAR but working as a nurse aide out of state uses an Out of State Employment Verification for MS Registry Renewal form rather than the reciprocity route.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Mississippi State Department of Health — CNA (Nurse Aide) Certification and Training (the state's CNA landing page). Establishes 'Our CNA registry is managed by Headmaster/TMU. To use the TMU online system for certification and renewal, first create an account by calling 800-393-8664'; 'To become a Certified Nurse Aide (CNA) you will need to enroll in a Mississippi state-approved nurse aide training program (NATP)'; the reciprocity eligibility statement tied to OBRA '87 and current good standing; the petition for removal of a finding of neglect after one year; the registry search and the downloadable misconduct list; the evaluator/proctor recruitment describing HDMaster as 'our CNA testing provider'; the contact point 'call the MSDH Licensure Division at 601-364-2718'; and the page's own 'Last reviewed on Aug 14, 2024' stamp. This is also the page that names the NNAAP — see the exam details on this page for the conflict that creates.\", \"url\": \"https://msdh.ms.gov/page/30,0,83,74.html\"}, {\"label\": \"MSDH — Nurse Aide Training Courses. Establishes that MSDH provides its approved-course list on request ('You can request a list of MSDH-approved nurse aide courses, by sending email to our Nurse Aide Office'), the Nurse Aide program phone numbers 601-364-2718 and 601-364-1100, and the link to the published program list. Carries a 'Last reviewed on Mar 31, 2026' stamp. Publishes no training-hour figure.\", \"url\": \"https://msdh.ms.gov/page/30,10669,83,74.html\"}, {\"label\": \"MSDH — Nurse Aide Training Programs in Mississippi (the approved-program list). Establishes the county-by-county roster of approved programs with each program's telephone number, address, county, approved status, and whether it is Facility or Non-Facility based.\", \"url\": \"https://msdh.ms.gov/page/resources/20816.pdf\"}, {\"label\": \"MSDH — Health Facilities regulations index. Establishes which Mississippi regulations exist for this subject: 'Certified Nurse Aides, Minimum Standards' and 'Institutions for the Aged or Infirm (Nursing Homes), Minimum Standards' are the only two that could carry nurse aide training rules, and neither sets training hours.\", \"url\": \"https://msdh.ms.gov/page/30,0,83,60.html\"}, {\"label\": \"MSDH — Minimum Standards for Certified Nurse Aides (Miss. Admin. Code Title 15, Part 3, Chapter 54). Establishes 'Only the licensing agency may flag and/or place adverse findings against a nurse aide... on the Nurse Aide Registry' (54.1.1), the definition of an aide as 'a certified nurse aide (CNA) who has met all requirements of the licensing agency and whose name appears on the Nurse Aide Registry' (54.3.9), the definition of the licensing agency as the Division of Licensure and Certification of MSDH (54.3.16), the ten-working-day notification duty (54.4.2), the 120-day hearing deadline and substantial-evidence standard (54.5.2, 54.5.4), the sixty-day final decision (54.5.5), the notice that the aide 'is not eligible to work in a long-term care facility in Mississippi' and the chancery court appeal (54.5.7), permanent retention of findings (54.6.3), the conviction/nolo shortcut (54.6.4) and restoration where the finding is not upheld (54.6.5).\", \"url\": \"https://msdh.ms.gov/page/resources/1757.pdf\"}, {\"label\": \"MSDH — Minimum Standards for Institutions for the Aged or Infirm (Miss. Admin. Code Title 15, Part 3, Chapter 45). Cited for a sourced negative: the nursing home standards contain no nurse aide training, hour or registry provision.\", \"url\": \"https://msdh.ms.gov/page/resources/119.pdf\"}, {\"label\": \"MSDH — Feeding Assistants. Establishes that the Feeding Assistant Program is separate from the nurse aide credential and is administered by the same MSDH Nurse Aide Training Program Coordinator. Carries a 'Last reviewed on Jul 14, 2025' stamp.\", \"url\": \"https://msdh.ms.gov/page/30,0,83,160.html\"}, {\"label\": \"Mississippi Nurse Aide Candidate Handbook, version 3.0, January 2026 — the examination and registry handbook published by MSDH's contractor and linked from MSDH's CNA page as 'Candidate handbook, knowledge and skills testing'. Establishes 'The Mississippi Department of Health (MSDH) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide tests and scoring services'; the MSNAR description; the 24-month renewal rule with 8 consecutive paid hours, the employer-verification mechanism, the qualifying and non-qualifying employment lists, the 30-day post-expiry window and the test-to-recertify rule; the military 120-day renewal provision; reactivation by examination and its one-attempt limit; the out-of-state reactivation criteria; the petition for removal of a finding of neglect including the January 1, 1995 cut-off and the 45-day decision; the reciprocity process and the $25 processing administrative assessment fee; the nursing student, graduate nurse and out-of-state/foreign nurse training waivers; the three-attempts-in-24-months and three-attempts-in-120-days testing rules; the exam fee table ($35 knowledge, $100 skills, $135 both) and the $10 audio surcharge; the $25 test review deposit and $35 refund processing fee; and the exam structure — 70 multiple-choice questions in 60 minutes with a 73% pass mark, the Mississippi subject-area blueprint, and the mandatory-plus-random skill task design.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Mississippi/forms/MS%20NA%20Candidate%20Handbook%201.2026.pdf\"}, {\"label\": \"D&S Diversified Technologies — Mississippi Nurse Aide (the contractor's Mississippi page, linked from MSDH as 'Headmaster/TMU'). Establishes 'D&SDT-Headmaster is honored to be approved by the Mississippi Department of Health to offer Certified Nurse Aide Testing and Registry Services to the Mississippi Health Care Community', the current candidate handbook version and date, and the candidate-facing form set including the Out of State Employment Verification for MS Registry Renewal.\", \"url\": \"https://hdmaster.com/testing/cnatesting/Mississippi/MS_CNA_Home.htm\"}, {\"label\": \"Mississippi TMU — Account Applications (the live applications list MSDH links to for renewal, waiver, reciprocity and petition filings). Establishes the published prices and descriptions for the CNA Reciprocity Form ($25.00, 'for placement on the Mississippi Nurse Aide Registry via Interstate Transfer'), Non-Employer Renewal ($25.00, 'for out-of-state work or if your employer no longer exists'), Out-of-State Certification Reactivation by Examination ($25.00), Test Review Request ($25.00), RN Test Observer/TASE ($100.00), and the three training waivers (Nursing Student, Graduate Nurse, Out-of-State or Foreign LPN or RN) with the instruction to call MSDH at (601) 364-1100 for an Approval to Test letter.\", \"url\": \"https://ms.tmutest.com/apply\"}, {\"label\": \"Mississippi TMU — Public registry search. Establishes the four search modes offered (Name, SSN, Registration Number, Misconduct) and the 'Download Misconduct List' option.\", \"url\": \"https://ms.tmutest.com/search\"}, {\"label\": \"42 C.F.R. 483.156 (eCFR). Establishes the federal registry frame including the express permission for a state to 'contract the daily operation and maintenance of the registry to a non-State entity' while retaining accountability, the bar on charging individuals for registration, the reservation of maltreatment findings to the state survey and certification agency, and the 24-consecutive-month removal rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR). Establishes the 75-clock-hour and 16-supervised-practical-hour federal minimums that apply where a state publishes no higher figure.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/ms-cna/"
  },
  {
   "page_id": "mt-cna",
   "state": "Montana",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Montana Department of Public Health and Human Services (DPHHS), Office of Inspector General — Certification Bureau, Montana Nurse Aide Registry (PO Box 202953, Helena MT 59620-2953; (406) 444-4980; cna@mt.gov). Not the Board of Nursing, and Montana's licensing department says so in its own words: 'The Montana Department of Labor & Industry's Professional Boards & Licensing Program does not regulate or issue certifications/licenses for Certified Nursing Assistants (CNAs). CNAs in Montana are credentialed by the Montana Department of Health and Human Services (DPHHS).' The competency examination is contracted out — 'The Montana Department of Health and Human Services has approved Headmaster, LLP to provide tests and scoring services for Montana nurse aide testing' — and the certificate itself is issued by DPHHS after a separate application.",
   "board_url": "https://dphhs.mt.gov/oig/certification/cna",
   "application_url": "https://mt-reports.com/portal/CertificateList.aspx",
   "renewal_cycle": "Renewal is online only, may be filed from 90 days before expiry, and is processed without human review. DPHHS: 'All renewals must now be completed online through the portal. Renewals will not be accepted by email. Certificates are able to renewed starting 90 days prior to expiration. Renewals completed through the BOUNDS portal are processed automatically. To verify your renewal, use the online verification.' Getting into the portal is itself a step: 'To renew your current Montana certificate you will need to create a BOUNDS portal account. Accounts are unique for each CNA and require an individual email address per CNA. If an email address was previously on file, an email invite to the portal has been sent. If you did not get an email, please go to the CNA Portal Registry Form', which asks for first name, last name, date of birth and registry number and then finds the profile. Creating the account requires 'your name as listed on your certificate and your certificate number', and DPHHS points anyone who does not know the number to the public registry search. What DPHHS does not publish, and this page will not invent: the length of the certificate term and the work requirement that has to be met to renew are not stated on the Montana Nurse Aide Registry page, in the Core Curriculum Requirements, in the Nurse Aide Training Program Application, or in the Montana Nurse Aide Candidate Handbook, which is a testing document and does not address renewal at all — all checked. The Administrative Rules of Montana, where such a rule would sit, could not be read at any address on that date. What is certain is the federal frame, which DPHHS itself publishes: a state 'must determine which individuals... do not qualify to remain on the registry because they have performed no nursing or nursing-related services for a period of 24 consecutive months', and 'The registry must remove entries for individuals who have performed no nursing or nursing-related services for a period of 24 consecutive months, unless the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property' (42 C.F.R. 483.156(b)(3), (c)(2)). Anyone renewing in Montana should confirm the current term and work requirement with the Nurse Aide Registry at (406) 444-4980 or cna@mt.gov before relying on a figure from anywhere else.",
   "ce_hours": "No continuing-education requirement for the Montana CNA certificate was found in any Montana source we checked, and this page therefore states none rather than guessing at one. The sources searched: the DPHHS Montana Nurse Aide Registry page including its renewal section; the DPHHS CNA/HHA Training Program Core Curriculum Requirements; the DPHHS Nurse Aide Training Program Application; the DPHHS Federal and State Regulations for CNAs document in full; the Montana Nurse Aide Candidate Handbook (February 2025, version 6) in full; the Montana Board of Nursing's CNA page; and the bounds portal's own application and renewal pages. The federal frame the registry sits inside conditions continued listing on paid nursing work rather than on education. Note the one Montana context where continuing education is real and is not this: the Montana Board of Nursing runs a continuing-education scheme for the credentials it does issue — LPN, RN, APRN and the two Medication Aide licenses — and publishes its own continuing-education guidance. That has no bearing on the DPHHS-issued CNA certificate. The Administrative Rules of Montana could not be read at any address on 2026-08-16, so this means the sources we could check are silent, not that no such rule exists; a reader who needs certainty should ask the Nurse Aide Registry directly.",
   "exam": "Two parts, both required: 'There are two parts to the nurse aide competency examination— a multiple-choice, knowledge/oral test, and a skill test. Exam candidates must be registered, complete approved training, pass both parts of the exam, and meet all other Montana Department of Health and Human Services requirements.' Knowledge — 'You will have a maximum of ninety (90) minutes to complete the 72-question multiple-choice Knowledge/Audio Exam', with a warning at fifteen minutes remaining, and 'You must have a 75% or better score to pass the knowledge portion of the exam.' The published Montana blueprint distributes those 72 questions as: Basic Nursing Skills 11, Infection Control 11, Safety 8, Personal Care 7, Communication 6, Care Impaired 5, Disease Process 5, Resident Rights 5, Role and Responsibility 5, Mental Health 4, Data Collection 3, Older Adult Growth & Development 2. An audio version is available for an extra fee, and for a knowledge retake only Montana offers a remotely proctored option taken from home. Skills — 'You will be allowed a maximum of thirty-five (35) minutes to complete your tasks. After 20 minutes have elapsed, you will be alerted that fifteen (15) minutes remain.' Three or four tasks are assigned, each introduced by a scenario read aloud by the RN Test Observer, and the personal care tasks noted in the handbook are demonstrated on a manikin. The pass rule is two-part and strict: 'You must correctly perform all of the key (critical) steps and 80% of all non-key steps on each task assigned to pass the Skill Test', restated as 'You must score 80% or better on each task without missing any key (critical) steps.' A candidate who realises they have made a mistake may say so and redo the step within the time allowed. Attempts — three, inside a six-month window from training completion; after six months 'your training expires, and you are no longer eligible to test based on this training cycle.' A challenge candidate gets one attempt at the whole exam and, on failing any part, must complete an approved training program before retesting. Results — 'Official test results will be available by signing in to your TMU© account after 6:00PM (MT) the business day after your test event.' A retake must be paid for again before a new date can be scheduled.",
   "fees": "Montana's published candidate costs are examination fees, charged by DPHHS'S testing contractor. The state-linked candidate handbook publishes the table: 'Knowledge Exam or Retake $20; Audio Knowledge Exam or Retake $31; Skill Exam or Retake $77' — so a candidate taking both parts pays $97, which is the total the handbook's own worked example shows ('20.00 / 77.00 / $97.00'). Payment is by Visa or MasterCard inside the testing system, and 'Testing fees must be paid before you can schedule a test date'; some training programs prepay for their graduates. A retake is charged again at the same rate. No DPHHS fee is published for the certificate itself, for interstate endorsement, for the nursing-student route, for a name change, or for renewal: the Montana Nurse Aide Registry page describes every one of those as an online application with no charge stated, and the federal rule the registry is built on forbids charging for the registration — 'The State may not impose any charges related to registration on individuals listed in the registry' (42 C.F.R. 483.156(b)(4)), a provision DPHHS reproduces in its own Federal and State Regulations for CNAs document. Training tuition is not a state price and DPHHS publishes none; the approved-program list is published as a spreadsheet of programs, not of prices. A test review request and an RN Test Observer application exist in the testing system as separate paid items on the contractor's side; neither is a cost of becoming certified. What this rests on: DPHHS publishes no fee schedule of its own on any page we checked, so the absence of a state fee is inferred from the absence of any published charge plus the federal prohibition, not from a Montana sentence saying 'no fee'.",
   "legal_basis": "[{\"citation\": \"42 C.F.R. Part 483, Subpart D — Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants (sections 483.150, 483.151, 483.152, 483.154, 483.156, 483.158 and 483.160), as published by DPHHS itself\", \"what_it_governs\": \"In Montana this is not merely the background frame — it is the text the state publishes as its own regulation reference, under the title 'Nurse Aide Training and Competency Testing Program — Federal and State Regulations for CNAs'. It supplies the 75-clock-hour training minimum and the 16 hours of supervised practical training (483.152(a)), the 16 hours of instruction required before any direct contact with a resident (483.152(b)(1)), the state's duty to review and approve training programs and to withdraw approval (483.151), the competency evaluation contents including the candidate's right to choose a written or oral examination and the randomly-drawn skills demonstration (483.154), the registry itself including the bar on charging individuals for registration, the reservation of abuse and neglect findings to the state survey agency, the 24-consecutive-month removal rule and the permanent retention of findings (483.156), federal financial participation (483.158), and the 8-hour paid feeding assistant course (483.160).\", \"url\": \"https://dphhs.mt.gov/assets/oig/CertificationBureau/FederalRegulationsforCNAs.pdf\"}, {\"citation\": \"Montana Department of Public Health and Human Services, Quality Assurance Division / Certification Bureau — Nurse Aide/Home Health Aide Training Course Core Curriculum Requirements (rev. 12/04)\", \"what_it_governs\": \"The content every approved Montana nurse aide training course must cover, in twelve parts, including the Montana-specific requirements that residents' rights instruction cover Montana residents' rights and that the abuse module cover the Montana Elder Abuse Act; the additional five topics for home health aides; and the standing rule that newly hired, uncertified nurse aides must receive 16 hours of classroom training before being assigned to resident care.\", \"url\": \"https://dphhs.mt.gov/assets/oig/CertificationBureau/CNAHHACoreCurriculumRequirements.pdf\"}, {\"citation\": \"Administrative Rules of Montana, Title 37 (Department of Public Health and Human Services)\", \"what_it_governs\": \"The department's rules generally. Named here as the body of law where a Montana-specific training-hour figure, certificate term, renewal work requirement or reinstatement rule would sit if one exists. No ARM text could be read as of August 16, 2026: every address on the state's rules site returns an empty application framework instead of rule text, so nothing on this page is quoted from the ARM and no ARM rule number is asserted.\", \"url\": \"https://rules.mt.gov/\"}]",
   "exam_vendor": "D&S Diversified Technologies (D&SDT)-Headmaster, LLP, under contract to DPHHS — and the contractor is a Montana company, headquartered in Helena, which is why DPHHS gives a local number for it. The appointment is stated in the state-linked handbook: 'The Montana Department of Health and Human Services has approved Headmaster, LLP to provide tests and scoring services for Montana nurse aide testing.' DPHHS names the same firm on its own registry page as the administrator of 'the Montana Certified Nurse Aide exams' and routes challenge requests to it: 'To challenge the CNA exams, please contact Headmaster at (406) 442-8656.' Montana does not use the NNAAP — the instrument is the Montana Nurse Aide Competency Exam, built to a state test plan: knowledge items are drawn from 'subject areas based on the MT DPHHS-approved Montana test plan.' Testing runs in the contractor's TestMaster Universe system at mt.tmutest.com, with a Knowledge Test Proctor for the written portion and an RN Test Observer for the skills portion. The boundary between the two organisations is explicit and worth knowing before you test: the contractor scores the exam and sends results to DPHHS electronically, but 'D&SDT-Headmaster does not issue certification.' The certificate comes from DPHHS, on a separate application, roughly 10 to 14 days later.",
   "training_hours": "Montana does not prescribe its own hour total, and the evidence for that is its own application form: the Nurse Aide Training Program Application asks each program to state 'Classroom Hours: ______ Clinical Hours: ______' rather than giving it a figure to meet. What DPHHS prescribes instead is content — a twelve-part Core Curriculum Requirements checklist a program must map week by week to its own textbook — plus one hard hour rule: 'Newly hired, uncertified nurse aides must receive 16 hours of classroom training prior to being assigned to resident care', covering communication and interpersonal skills, fostering independence, residents' rights including Montana law, safety, and basic infection control. The hour floor that does apply in Montana is the federal one, and DPHHS publishes it itself. The Certification Bureau's own document, titled 'Nurse Aide Training and Competency Testing Program — Federal and State Regulations for CNAs', reproduces 42 C.F.R. 483.152(a) in full: a program must '(1) Consist of no less than 75 clock hours of training; (2) Include at least the subjects specified in paragraph (b) of this section; (3) Include at least 16 hours of supervised practical training. Supervised practical training means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse.' So the answer a Montana reader needs is: at least 75 clock hours, of which at least 16 are supervised practical training, with the specific classroom and clinical split set by the individual approved program and stated on its approval application. Sources checked for a Montana-specific number: the DPHHS Montana Nurse Aide Registry page; the CNA/HHA Training Program Core Curriculum Requirements document in full; the Nurse Aide Training Program Application in full; the DPHHS Federal and State Regulations for CNAs document in full; the Montana Nurse Aide Candidate Handbook (February 2025, version 6) in full; the Montana Board of Nursing's CNA page; and the Administrative Rules of Montana, which could not be read at all on 2026-08-16 because every rules.mt.gov address returned only an empty page shell rather than rule text. One more DPHHS document exists and is not published: 'To request a copy of the State Plan for Nurse Aide Training Program, email cna@mt.gov.' If Montana states an hour total anywhere, that unpublished state plan is the most likely place.",
   "lapse_rule": "What Montana publishes about lapse is the federal rule, not a Montana one. DPHHS's own Federal and State Regulations for CNAs document reproduces 42 C.F.R. 483.156, under which the state 'must determine which individuals... do not qualify to remain on the registry because they have performed no nursing or nursing-related services for a period of 24 consecutive months', and 'The registry must remove entries for individuals who have performed no nursing or nursing-related services for a period of 24 consecutive months, unless the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property.' The same document carries the federal deeming and waiver provisions at 42 C.F.R. 483.150, under which a state may waive the competency evaluation for someone who 'has served as a nurse aide at one or more facilities of the same employer in the state for at least 24 consecutive months before December 19, 1989' — historical, but it is the text Montana publishes. What DPHHS does not publish is a Montana-specific reinstatement pathway: no grace period, no reactivation-by-examination route and no retraining rule appears on the Montana Nurse Aide Registry page, in the candidate handbook or in any other Montana source we checked, and the Administrative Rules of Montana could not be read at any address that day. Two adjacent Montana rules that do operate like lapse rules and are published: training expires before the credential does — 'You have three (3) attempts to pass the competency exam's knowledge and skills test portions within six (6) months from your date of nurse aide training program completion. After six months, your training expires, and you are no longer eligible to test based on this training cycle'; and a failed challenge closes that route permanently until an approved training program is completed. Findings of abuse, neglect or misappropriation are handled under the federal registry rules DPHHS publishes: only the state survey and certification agency may place them, they must be entered within 10 working days, and they 'must remain in the registry permanently, unless the finding was made in error, the individual was found not guilty in a court of law, or the State is notified of the individual's death.' Anyone whose Montana certificate has lapsed should contact the Nurse Aide Registry at (406) 444-4980 or cna@mt.gov rather than assume another state's rule applies.",
   "reciprocity": "Montana calls it interstate endorsement, and the entry condition is unusually wide: 'Those with a current Certified Nurse Aide (CNA) registration in at least one US State or Territory can apply for Interstate Endorsement in Montana.' Note what that sentence does not require — it does not name a work-history test, a minimum number of hours, or a Montana examination. How it is filed: 'To apply for Interstate Endorsement, go to the bounds Portal and select the Certified Nurse Aide type and the CNA Interstate Endorsement Application. This Interstate Endorsement application is a two step process. After you have created your bounds portal, you will receive an email at the address you provided, click on the bounds portal activation. At this point your portal will be activated and you need to complete the Interstate Endorsement application. You must enter at least one, current Certified Nurse Aide (CNA) number.' The portal lists the same transaction as 'CNA Interstate Endorsement (reciprocity)'. No fee is published for it. A trap for anyone who applied the old way: 'If you previously applied for Interstate Endorsement by email or using the access.gov form, and you cannot find your name/certificate using the online verification, you must reapply using the BOUNDS portal.' The one door Montana closes outright is the home health aide credential: 'The Montana Nurse Aide Registry does not accept Home Health Aide Interstate Endorsements.' A home health aide from another state must first obtain a Montana CNA certificate and then complete additional home health aide training through a Montana home health provider, whose staff submit the endorsement application and skills competency checklist to DPHHS. Transferring out of Montana is not addressed on any DPHHS page we checked; the public registry search is what another state's registry would use to confirm a Montana certificate.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Montana Department of Public Health and Human Services — Montana Nurse Aide Registry (the program's own page). Establishes the Certification Bureau's contact details; 'All Certified Nurse Aide Applications are now online through the BOUNDS portal. PDF and paper applications are no longer accepted'; the renewal rules ('All renewals must now be completed online through the portal. Renewals will not be accepted by email. Certificates are able to renewed starting 90 days prior to expiration. Renewals completed through the BOUNDS portal are processed automatically'); the portal account requirements; the interstate endorsement condition ('Those with a current Certified Nurse Aide (CNA) registration in at least one US State or Territory can apply') and its two-step process; the CNA by Exam route and the role of D&S Diversified Technologies; the Montana nursing student route with the full college-by-college course table; the flat refusal of Home Health Aide interstate endorsements and the Montana-only route to that endorsement; the feeding assistant program approval process; 'To challenge the CNA exams, please contact Headmaster at (406) 442-8656'; and 'To request a copy of the State Plan for Nurse Aide Training Program, email cna@mt.gov.'\", \"url\": \"https://dphhs.mt.gov/oig/certification/cna\"}, {\"label\": \"DPHHS Certification Bureau — Nurse Aide/Home Health Aide Training Course Core Curriculum Requirements. Establishes the twelve required curriculum areas including the Montana residents' rights and Montana Elder Abuse Act items, the 'CPR (recommended, not mandatory)' line, the five additional home health aide topics, and the requirement that newly hired uncertified nurse aides receive 16 hours of classroom training in five named subjects before being assigned to resident care.\", \"url\": \"https://dphhs.mt.gov/assets/oig/CertificationBureau/CNAHHACoreCurriculumRequirements.pdf\"}, {\"label\": \"DPHHS Certification Bureau — Nurse Aide Training Program Application. Establishes what a Montana training program must submit (program coordinator, clinical instructor and supplemental instructor applications, curriculum or textbook, class schedule, core curriculum requirements checklist), the 90-day response window, and — importantly for the hours question — that the form asks the applicant to state 'Classroom Hours: ______ Clinical Hours: ______' rather than prescribing a figure.\", \"url\": \"https://dphhs.mt.gov/assets/oig/CertificationBureau/NATPApplication.pdf\"}, {\"label\": \"DPHHS Office of Inspector General, Certification Bureau — Nurse Aide Training and Competency Testing Program: Federal and State Regulations for CNAs. The document Montana publishes as its regulation reference. Establishes 42 C.F.R. 483.150 through 483.160 verbatim, including 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training' (483.152(a)), the 16 hours before direct resident contact (483.152(b)(1)), the registry provisions including 'The State may not impose any charges related to registration on individuals listed in the registry' and the 24-consecutive-month removal rule (483.156), and the 8-hour paid feeding assistant course (483.160).\", \"url\": \"https://dphhs.mt.gov/assets/oig/CertificationBureau/FederalRegulationsforCNAs.pdf\"}, {\"label\": \"Montana Board of Nursing (Department of Labor & Industry) — CNA. Establishes the sourced negative that settles who issues the credential: 'The Montana Department of Labor & Industry's Professional Boards & Licensing Program does not regulate or issue certifications/licenses for Certified Nursing Assistants (CNAs). CNAs in Montana are credentialed by the Montana Department of Health and Human Services (DPHHS). In order to be certified, nurse aides must pass a state competency evaluation and successfully perform all expected nurse aide duties in a training or employment capacity.' Also establishes, by its own navigation, that the Board does license Medication Aide I and Medication Aide II alongside LPN, RN and APRN.\", \"url\": \"https://boards.bsd.dli.mt.gov/nursing/license-information/cna\"}, {\"label\": \"Montana Nurse Aide Candidate Handbook, effective February 2025, version 6 — the examination handbook published by DPHHS's testing contractor and linked from the contractor's Montana page. Establishes 'The Montana Department of Health and Human Services has approved Headmaster, LLP to provide tests and scoring services for Montana nurse aide testing'; the two-part exam description; the one-time challenge rule and the consequence of failing it; the exam fee table ($20 knowledge, $31 audio knowledge, $77 skills, $97 for both); the three attempts within six months of training completion and the expiry of training after six months; the knowledge exam format (72 multiple-choice questions, 90 minutes, 75% to pass) and its twelve-area Montana blueprint; the 35-minute skills test and the rule that all key steps and 80% of non-key steps must be correct; the results timetable; and the boundary statement that 'D&SDT-Headmaster does not issue certification' with 'Certification is issued by the Montana Department of Health and Human Services (DPHH) after you have completed all requirements' about 10 to 14 days after the DPHHS application is submitted.\", \"url\": \"https://hdmaster.com/testing/cnatesting/montana/mtformpages/forms/MTNA%20CandidateHandbook%202.2025.pdf\"}, {\"label\": \"D&S Diversified Technologies — Montana (the testing contractor's Montana page, linked from DPHHS). Establishes 'Montana CNA Testing and Certification', the current candidate handbook version and effective date, the challenge instructions and challenge application, the link back to the 'MT DPHHS Certified Nurse Aide Application', and the contractor's Helena, Montana base.\", \"url\": \"https://hdmaster.com/testing/cnatesting/montana/MT_CNA_Home.htm\"}, {\"label\": \"Montana bounds portal — Nurse Aide Registry Online Verification. Establishes the live search form's own fields (first name and last name required, middle name, city, ZIP, certificate number) and the license-type menu offering 'Certified Nurse Aide' and 'CNA Home Health Aide Endorsement'.\", \"url\": \"https://mt-reports.com/portal/searchcertificate.aspx\"}, {\"label\": \"Montana bounds portal — certificate application. Establishes the four application reasons Montana offers for the Certified Nurse Aide type: 'CNA by Montana Exam', 'CNA Interstate Endorsement (reciprocity)', 'Montana Nursing Student' and 'Name Change for CNA', together with the personal details the application collects.\", \"url\": \"https://mt-reports.com/portal/CertificateList.aspx\"}, {\"label\": \"Montana bounds portal — CNA Registry Form. Establishes the route DPHHS gives to a CNA who never received a portal invitation: find the existing profile by first name, last name, date of birth and registry number, with a link to look the registry number up.\", \"url\": \"https://mt-reports.com/portal/CNARegistryForm.aspx\"}, {\"label\": \"42 C.F.R. 483.156 (eCFR). The authoritative current text of the registry rule Montana publishes, including the permission to contract daily registry operation to a non-state entity, the bar on charging individuals for registration, and the 24-consecutive-month removal rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}, {\"label\": \"42 C.F.R. 483.152 (eCFR). The authoritative current text of the training-program rule Montana publishes, including the 75-clock-hour minimum, the 16 hours of supervised practical training and its definition, and the 16 hours required before any direct contact with a resident.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/mt-cna/"
  },
  {
   "page_id": "nc-cna",
   "state": "North Carolina",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "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 on this page.",
   "board_url": "https://info.ncdhhs.gov/dhsr/hcpr/index.html",
   "application_url": "https://ncnar.ncdhhs.gov/ri-forms.html",
   "renewal_cycle": "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.",
   "ce_hours": "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. Sources checked: 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 page does not present it as one.",
   "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 page states no score or question count.",
   "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 we checked addresses employer reimbursement of training or testing costs, so this page 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.",
   "legal_basis": "[{\"citation\": \"N.C. Gen. Stat. § 131E-255 (Nurse Aide Registry; waiver of rules during an emergency), as amended by S.L. 2022-74 (H.B. 103), ss. 9E.1(a), 9E.2(h)\", \"what_it_governs\": \"The statutory command to run the registry — 'the Department shall establish and maintain a registry containing the names of all nurse aides working in nursing facilities in North Carolina' — plus the recording of findings of resident neglect, abuse or misappropriation, the aide's right to a contested-case hearing within 30 days of notice, the good-faith immunity for reporting and for employer use of registry information, the rulemaking delegation to the Commission, the four-month allowance for employing unlisted health care personnel in a nursing facility, and the Division's power to waive registry rules temporarily during a declared emergency.\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_131E/GS_131E-255.html\"}, {\"citation\": \"N.C. Gen. Stat. § 93B-15.3 (Licensure recognition for individuals licensed in neighboring states), enacted by S.L. 2025-61, s. 1(a)\", \"what_it_governs\": \"Reciprocity Pathway #2. Requires a covered board to issue a license, certification or registration to an applicant who establishes North Carolina residence and who holds a current credential in Georgia, South Carolina, Tennessee, Virginia or West Virginia at the same or substantially equivalent practice level, has held it at least one year, passed any required examination, is in good standing everywhere, has no surrender or revocation for unprofessional conduct, no pending discipline, no disqualifying criminal record under G.S. 93B-8.1, and has paid applicable fees. Also limits the resulting credential to North Carolina and preserves the ordinary pathway as an alternative.\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_93B/GS_93B-15.3.html\"}, {\"citation\": \"10A N.C. Admin. Code 13O.0301 (Nurse Aide I Training and Competency Evaluation), eff. January 1, 2016; emergency amendment eff. April 20, 2020; temporary amendment eff. June 26, 2020; amended eff. April 1, 2021\", \"what_it_governs\": \"The two eligibility routes onto the Nurse Aide I Registry; the full reciprocity application contents and the Department's verification duties; the 10-business-day response and 3-business-day listing deadlines; the incorporation of 42 CFR Part 483 Subpart D by reference; the scope of the competency examination and the rule that only the Department or its contracted testing agent may administer and evaluate it; the 30-day recording deadline; the duty to tell a failing candidate which areas they failed; the three-attempt limit before retraining; and the training exemption for military medical corpsmen and retired or non-practicing nurses.\", \"url\": \"http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20o/subchapter%20o%20rules.html\"}, {\"citation\": \"10A N.C. Admin. Code 13O.0101 and.0102 (Health Care Personnel Registry — definitions; investigating and reporting)\", \"what_it_governs\": \"The definitions of abuse, neglect, misappropriation, fraud, diversion of drugs, finding, health care facility and health care personnel that govern what appears against a name on the registry, and the 24-hour facility reporting duty for allegations against health care personnel.\", \"url\": \"http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20o/subchapter%20o%20rules.html\"}, {\"citation\": \"42 C.F.R. §§ 483.150–483.158 and 42 C.F.R. § 483.35(d); 42 U.S.C. § 1395i-3(e) and § 1396r(e)\", \"what_it_governs\": \"The federal nurse aide training, competency evaluation and registry scheme that North Carolina implements and, in 10A NCAC 13O.0301(e), incorporates by reference — including the program-approval standards (483.151–483.152) that North Carolina applies in place of a state-specific hour count, the competency evaluation standards (483.154), the registry and 24-month work rule (483.156), and the four-month allowance for unlisted staff (483.35(d)) that G.S. 131E-255(f) tracks. Cited here because DHSR cites them as the operative standards; the federal texts themselves were not separately read for this page.\", \"url\": \"https://ncnar.ncdhhs.gov/naregulations.html\"}]",
   "exam_vendor": "Credentia, under state contract, administering the National Nurse Aide Assessment Program (NNAAP) examination. DHSR states the relationship twice in its own words: 'Credentia is the state-contracted provider of Nurse Aide I competency evaluation (testing). Credentia works to schedule and provide tests' (Nurse Aide I Registry page), and 'Credentia is the state-approved examination vendor that administers the National Nurse Aide Assessment Program (NNAAP) examination' (State Examination page). The curriculum Guidance repeats it for instructors: 'Credentia is the state-approved testing vendor and administers the National Nurse Assistant Assessment Program (NNAAP) examination. The examination tests minimal competency.' DHSR also routes two adjacent functions through the same vendor: training-waiver applications ('The Division of Health Service Regulation has partnered with Credentia to process training waiver requests') and exam-concern reporting. Candidates get the candidate handbook from their training program instructor, from the vendor's site, or by calling 1-888-723-6773 or 1-888-204-6249. The vendor is named here because the state names it; the exam-day details on this page are attributed to the vendor's North Carolina candidate handbook, and every other fact to a state source.",
   "training_hours": "North Carolina sets the binding hour count per program — but DHSR does state a floor and a suggested structure, and they live in the blank program application rather than on the requirements pages. Under 'Important Notices', DHSR's Nurse Aide I Initial Application (the form linked from its Nurse Aide Training page under 'For Training Programs Only') states: 'The North Carolina Division of Health Service Regulation will not approve a training program to have at minimum 75 clock hours based on the expectations of the Nurse Aide role in a clinical setting. The suggested program hours for a new training program are 36 classroom hours, 52 laboratory hours, and 32 clinical hours.' And in a separate paragraph of the same notice: 'Per the Medicare State Operations Manual, North Carolina has the discretion to require additional clock hours of instruction above the minimum required 75 clock hours.' The suggested structure totals 120 hours (36 + 52 + 32), and the plain effect of the first sentence is that a new program pitched at the bare federal 75-hour minimum will not be approved. The binding figure is still per-program. (1) DHSR's Education Requirements page states the requirement as program approval: 'Individuals must successfully complete a state-approved Nurse Aide I Training and Competency Evaluation Program (NATCEP) or a state-approved Competency Evaluation Program (CEP). The North Carolina Division of Health Service Regulation partners with training programs to determine the number of clock hours needed to provide an educationally sound program that meets today's workforce demands. While federal regulations require a minimum of 75 clock hours for approval, per the CMS State Operations Manual, each State may require additional training hours at its discretion.' (2) The state-approved curriculum's Guidance document sends the question to the individual program: 'Clock Hours of Instruction — Refer to your training program's approved Nurse Aide I application to determine the clock hours of instruction approved by the Division of Health Service Regulation.' DHSR's Reapproval Application confirms it holds binding per-program figures — its review checklist requires that 'Totals for class hours, lab hours, and clinical hours are included and equal to State-approved totals. (1 class hour of instruction is equal to 60 minutes)'. (3) The rule fixes the standard by federal cross-reference: a listed person must 'pass a Nurse Aide I training program approved by the Department in accordance with 42 CFR 483.151 through 42 CFR 483.152' (10A NCAC 13O.0301(a)(1)). Reciprocity figure: the Verify Registry Listings page requires an incoming aide to have 'completed and passed a 75-hour (or more) state-approved nurse aide training and competency evaluation program that meets the requirements of 42 CFR Part 152 or a state-approved competency evaluation program that meets the requirements of 42 CFR Part 154.' Pre-contact threshold: 'Modules A through G meet the federal regulation 42 CFR § 483.152 requirements specific to requiring a minimum of sixteen (16) hours of training prior to any direct contact with a resident' (curriculum Guidance) — corroborated by the Reapproval checklist item 'A minimum of 16 clock hours of training prior to any direct contact with a resident.' Sources checked: 10A NCAC 13O in full, the DHSR Education Requirements page, the Nurse Aide I Registry page and FAQ, the 2024 State-Approved Curriculum landing page and Guidance, the Verify Registry Listings page, and DHSR's Nurse Aide I Initial Application and Reapproval Application documents.",
   "lapse_rule": "Miss the work requirement and you start over — training and testing both. DHSR states it under the heading Required Re-testing: 'A new N.C. state-approved Nurse Aide I training and competency testing is required if a nurse aide does not perform at least 8 hours of qualified work during any 24-month period.' The FAQ says the same thing from the other direction: 'When is retraining required? When an individual does not meet the requirements to renew their listing on the North Carolina Nurse Aide I Registry.' One escape hatch, and it has to be used before the listing dies: eligibility route E10 covers 'applicants listed as active and in good standing status on the North Carolina Nurse Aide I Registry but do not meet the requirements for registry listing renewal.' Those candidates 'should seek approval from the Division of Health Service Regulation by completing a training waiver. Candidates may apply to take the state-approved nurse aide competency exam within 90 days prior to their North Carolina Nurse Aide I Registry listing expiration date. Candidates have three (3) attempts to pass both the written and the skills exam before their listing expiration date.' So an aide who sees the work requirement slipping can re-qualify by examination alone — but only inside that 90-day window and only while the listing is still active. Two groups exempt from the retraining part: 'U.S. military personnel who have completed medical corpsman training and retired or non-practicing nurses shall not be required to take the Department-approved Nurse Aide I training program to be listed or relisted on the Nurse Aide I Registry, unless the person fails to pass the State of North Carolina's Nurse Aide I competency exam after three attempts' (10A NCAC 13O.0301(k)). A lapsed listing is a bar on working, not a grace period: 'Individuals must be listed on the North Carolina Nurse Aide I Registry prior to working as a Nurse Aide in North Carolina.' Separately and permanently: a substantiated finding of resident abuse, neglect or misappropriation of resident property in a nursing home is recorded on the registry and nursing homes 'may not employ' that person.",
   "reciprocity": "Two pathways, evaluated in a fixed order, and one of them is new. DHSR's reciprocity FAQ: 'Pathway #1 – Applies to North Carolina rule 10A NCAC 13O.0301 that went into effect in 2021. Pathway #2 – Applies to North Carolina general statute § 93B-15.3 that went into effect in 2025.' The order is not optional: 'DHSR will first evaluate your application under Pathway #1 to determine whether you meet the requirements for reciprocity. If your application is denied under Pathway #1, DHSR will then review it under Pathway #2.' And it does not run both when the first succeeds: 'If your application meets the reciprocity requirements under Pathway #1, DHSR will not evaluate it under Pathway #2.' Pathway #1 — open to candidates from all states. From the Reciprocity Application (Form #4515, June 2026): successful completion of a state-approved nurse aide competency evaluation program; active and good-standing status on another state's registry of nurse aides; no pending or substantiated finding of abuse, neglect, exploitation or misappropriation of resident or patient property on any nurse aide registry; and, within the past 24 months, at least one of — 'In accordance with federal regulation 42 CFR § 483.156, worked as a nurse aide for a minimum of eight hours, for pay, performing nursing or nursing-related services under the delegation and supervision of a registered nurse; or In accordance with federal regulation 42 CFR § 483.154, passed the state-approved nurse aide competency evaluation (examination) program.' Two disqualifiers are stated flatly: 'Temporary or provisional statuses will not be accepted' and 'Private duty or virtual nurse aide employment or duties will not be accepted.' No background check is required on this pathway ('Pathway #1 – No'), and a P.O. Box address is acceptable. Pathway #2 — five states only, and only after a pathway #1 denial. It is available to candidates from South Carolina, Georgia, Tennessee, Virginia or West Virginia — the five states named in G.S. 93B-15.3(b)(1), which requires an occupational or State agency licensing board to 'issue a license, certification, or registration to any applicant who establishes residence in this State' and who is 'currently licensed, certified, or registered in Georgia, South Carolina, Tennessee, Virginia, or West Virginia... for at least one year,' has passed any required examination, is in good standing everywhere, has never surrendered or had revoked a credential for unprofessional conduct, has no active or pending discipline, and 'does not have a disqualifying criminal history record, as determined by... G.S. 93B-8.1.' DHSR's application restates those as: completion of the competency evaluation in the reciprocity state; active status on that state's nurse aide registry for at least one year; good standing on all state nurse aide registries; no voluntary surrender or revocation for unprofessional conduct; no active or pending unresolved disciplinary action; clean state and federal background check; and 'Established North Carolina residency (P.O. Box addresses are not accepted).' The background check is the candidate's job: 'Will DHSR complete the federal and state background checks? No. It is the candidate's responsibility to complete the required background checks before submitting the reciprocity application.' Timing and filing: the application goes to DHSR by mail or by email in PDF or Word format — 'DHSR will accept photos of identification documents; however, photos of the application will not be accepted' — and 'DHSR will review your application and respond within 10 business days of receipt.' An expired out-of-state listing kills both pathways: 'Your nurse aide listing must be active on the registry to be considered for reciprocity under either pathway.' A rule-level detail worth knowing before filing: the good-standing documentation must be 'dated no older than 30 calendar days prior to the date the application is received by the Department' (10A NCAC 13O.0301(b)(2)). Going the other way: DHSR does not help. 'I'm moving to another state. May I perform nurse aide duties in another state? You must contact the registry in the other state to determine their requirements.' And an approval under Pathway #2 carries no weight elsewhere — G.S. 93B-15.3(f): a credential granted under that section 'shall be valid only in this State and does not extend validity to other jurisdictions.'",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"N.C. DHSR — N.C. Nurse Aide I Registry. The core page. Establishes what the registry is ('a registry of all people who meet the state and federal training and testing requirements to perform Nurse Aide I tasks'), who must be listed ('anyone who works as a nurse aide in a nursing home... includes RNs, LPNs, and Nurse Aide IIs'), the three routes onto it, the training-waiver and reciprocity eligibility conditions for out-of-state aides, the licensed-nurse listing route, 'Credentia is the state-contracted provider of Nurse Aide I competency evaluation (testing)', the name/address change duty, the full renewal rule ('at least 8 hours... during every two years', the four qualifying criteria, the RN signature rule, and 'The renewal is for 24 months, beginning from the last qualified work date'), and Required Re-testing.\", \"url\": \"https://ncnar.ncdhhs.gov/ncna.html\"}, {\"label\": \"N.C. DHSR — Nurse Aide I FAQ. Establishes 'There are no registry fees' for both listing and renewal, 'You will not receive a card', 'Individuals are listed... within 5 business days after successfully completing the exam', 'Credentia administers the National Nurse Aide Assessment Program (NNAAP) examination', 'North Carolina is a reciprocity state per 10A NCAC 13O.0301', the listing-period calculation and the November 2007 end-of-month rule, the qualifying and non-qualifying work lists including the private-duty exclusion and its CAP/DA and CAP/C carve-outs, 'The paper renewal form will no longer be accepted by DHSR after August 31, 2021', 'It is the responsibility of the Nurse Aide I to know when their listing expires', and the Nurse Aide II referral to the North Carolina Board of Nursing.\", \"url\": \"https://ncnar.ncdhhs.gov/faq.html\"}, {\"label\": \"N.C. DHSR — Verify Registry Listings. The public lookup page. Establishes the five registries covered, the last-4-SSN-plus-name search and the ITIN warning, the confirmation-number requirement for employers ('The confirmation number is the employer's proof of access'), the employer duties to check before hiring, the work restrictions on substantiated findings, and the single North Carolina statement of an hour figure: an aide qualifying by reciprocity must have 'completed and passed a 75-hour (or more) state-approved nurse aide training and competency evaluation program that meets the requirements of 42 CFR Part 152 or a state-approved competency evaluation program that meets the requirements of 42 CFR Part 154.'\", \"url\": \"https://ncnar.ncdhhs.gov/verify_listings1.jsp\"}, {\"label\": \"N.C. DHSR — Education Requirements. Establishes that the requirement is a state-approved NATCEP or CEP meeting 42 CFR 483.152 or 483.154, that 'The North Carolina Division of Health Service Regulation partners with training programs to determine the number of clock hours needed', and that 'While federal regulations require a minimum of 75 clock hours for approval, per the CMS State Operations Manual, each State may require additional training hours at its discretion' — without announcing a North Carolina figure above the federal floor.\", \"url\": \"https://ncnar.ncdhhs.gov/naedureq.html\"}, {\"label\": \"N.C. DHSR — State Examination. Establishes 'Credentia is the state-approved examination vendor that administers the National Nurse Aide Assessment Program (NNAAP) examination' and the five-student minimum for a skills evaluation event ('Otherwise, a testing event will be cancelled').\", \"url\": \"https://ncnar.ncdhhs.gov/nacompeva.html\"}, {\"label\": \"N.C. DHSR — Fees (Nurse Aide I examination). The state-published price table: initial written plus skills $140 (oral English or Spanish likewise $140), written-only retest $40, oral written-only retest $40, skills-only retest $100 — with DHSR's own 'New Price Beginning January 1, 2027' column at $145, $145, $45, $45 and $100.\", \"url\": \"https://ncnar.ncdhhs.gov/na1-exam-fees.html\"}, {\"label\": \"N.C. DHSR — Eligibility Types and Requirements. Establishes eligibility routes E1, E3, E5, E8, E9 and E10 and their conditions, and the deadline rules: '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', with the variant clocks for waiver routes and the 90-day pre-expiry window for E10.\", \"url\": \"https://ncnar.ncdhhs.gov/na1-exam-eligibility.html\"}, {\"label\": \"N.C. DHSR — Nursing Homes, 120 Day Rule. Establishes the four-month allowance and its conditions: 'Effective July 1, 2022, G.S. § 131E-255, was amended by House Bill 103 (Session Law 2022-74)'; full-time employment and active progress toward training and testing; the bans on terminate-and-rehire, on restarting after more training, and on waiving background checks; the cumulative cross-employer limit; and the exclusion of NAT-program clinical time from the count.\", \"url\": \"https://ncnar.ncdhhs.gov/nursinghomes120.html\"}, {\"label\": \"N.C. DHSR — Nurse Aide I Reciprocity Application, Form #4515 (June 2026). Establishes the Pathway #1 and Pathway #2 eligibility lists verbatim, the 'Temporary or provisional statuses will not be accepted' and 'Private duty or virtual nurse aide employment or duties will not be accepted' exclusions, the Pathway #2 background-check and North Carolina residency conditions ('P.O. Box addresses are not accepted'), the filing channels, and 'DHSR will review your application and respond within 10 business days of receipt.'\", \"url\": \"https://ncnar.ncdhhs.gov/pdf/Reciprocity_Application.pdf\"}, {\"label\": \"N.C. DHSR — Reciprocity & Frequently Asked Questions. Establishes the two pathways and their legal bases ('Pathway #1 – Applies to North Carolina rule 10A NCAC 13O.0301 that went into effect in 2021. Pathway #2 – Applies to North Carolina general statute § 93B-15.3 that went into effect in 2025'), the fixed evaluation order, the five Pathway #2 states, the one-year minimum listing, the requirement that the out-of-state listing be active, the P.O. Box difference between pathways, and 'It is the candidate's responsibility to complete the required background checks before submitting the reciprocity application.'\", \"url\": \"https://ncnar.ncdhhs.gov/pdf/FAQ_October_June%202026.pdf\"}, {\"label\": \"N.C. DHSR — Training Waivers. Establishes that 'The Division of Health Service Regulation has partnered with Credentia to process training waiver requests' and that waiver applications for eligibility types E8, E9 and E10 are filed through the vendor's platform.\", \"url\": \"https://ncnar.ncdhhs.gov/trainingwaivers.html\"}, {\"label\": \"N.C. DHSR — State-Approved Nurse Aide I Curriculum (July 2024), Guidance document. Establishes 'Credentia is the state-approved testing vendor and administers the National Nurse Assistant Assessment Program (NNAAP) examination. The examination tests minimal competency', the per-program hours rule ('Refer to your training program's approved Nurse Aide I application to determine the clock hours of instruction approved by the Division of Health Service Regulation'), the 75-minimum passing grade for theory, the pass/fail laboratory component and live-demonstration rule, and that 'Modules A through G meet the federal regulation 42 CFR § 483.152 requirements specific to requiring a minimum of sixteen (16) hours of training prior to any direct contact with a resident.'\", \"url\": \"https://info.ncdhhs.gov/dhsr/hcpr/curriculum/pdf/2024/Guidance.pdf\"}, {\"label\": \"10A N.C. Admin. Code Subchapter 13O (Health Care Personnel Registry), full subchapter text on the N.C. Office of Administrative Hearings rules site. Establishes rule.0301 in full — the two listing routes, the reciprocity application and verification requirements, the 30-days-or-newer documentation rule, the 10-business-day and 3-business-day deadlines, the examination administration and recording rules, the three-attempt retraining trigger, and the military-corpsman and retired-nurse training exemption — plus the.0101 definitions and the.0102 24-hour reporting duty.\", \"url\": \"http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013%20-%20nc%20medical%20care%20commission/subchapter%20o/subchapter%20o%20rules.html\"}, {\"label\": \"N.C. Gen. Stat. § 131E-255, from the North Carolina General Assembly. Establishes 'the Department shall establish and maintain a registry containing the names of all nurse aides working in nursing facilities in North Carolina', the recording of abuse, neglect and misappropriation findings, the 30-day contested-case window, the good-faith immunities, and subsection (f)'s four-month allowance for employing unlisted health care personnel.\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_131E/GS_131E-255.html\"}, {\"label\": \"N.C. Gen. Stat. § 93B-15.3, from the North Carolina General Assembly. Establishes the neighbouring-state recognition scheme behind reciprocity Pathway #2, including the five named states, the one-year minimum, the good-standing and discipline conditions, the G.S. 93B-8.1 criminal-history test, the North Carolina residency condition, and the limits in subsections (f) through (h).\", \"url\": \"https://www.ncleg.gov/EnactedLegislation/Statutes/HTML/BySection/Chapter_93B/GS_93B-15.3.html\"}, {\"label\": \"N.C. DHSR — Health Care Personnel Education and Credentialing Section (the section's own landing page). Establishes the operating unit's identity and its list of responsibilities: 'Nurse Aide I – registry, training and competency programs', the Medication Aide, Geriatric Aide, Home Care Aide and Feeding Assistant programs, and 'Public registry access and listing verification', plus the Registry Office contact details.\", \"url\": \"https://info.ncdhhs.gov/dhsr/hcpr/index.html\"}, {\"label\": \"N.C. DHSR — Unlicensed Assistive Personnel (UAP). Establishes that the North Carolina Board of Nursing's umbrella term UAP covers Nurse Aides (NA), Certified Nursing Assistants (CNA), Patient Care Aides, Home Health Aides, Patient Care Technicians, Medical Office Assistants, Medical Assistants, Medication Aides and Medication Technicians — the basis for the naming discussion under What it's called.\", \"url\": \"https://ncnar.ncdhhs.gov/nauap.html\"}, {\"label\": \"N.C. DHSR — Regulations. The state's own list of the federal and state authorities governing nurse aides: OBRA 1987/1989/1990, 42 U.S.C. § 1395i-3(e) and (g)(1)(C), 42 U.S.C. § 1396(r)(e) and (g)(1)(C), 42 CFR 483 Subparts B and D, G.S. ch. 131E Article 15, 10A NCAC ch. 13 Subchapters D and O, and 21 NCAC 36.0401,.0402,.0403 and.0405.\", \"url\": \"https://ncnar.ncdhhs.gov/naregulations.html\"}, {\"label\": \"DHSR Nurse Aide I Initial Application (blank program application; 'Important Notices' carries the 75-hour approval floor and the suggested 36/52/32 structure).\", \"url\": \"https://info.ncdhhs.gov/dhsr/hcpr/doc/NewProgram_Nurse%20Aide_InitialApplication.docx?ver=1.9\"}, {\"label\": \"DHSR Nurse Aide I Reapproval Application (review checklist: totals must equal State-approved totals; 16 pre-contact hours as an audit item).\", \"url\": \"https://info.ncdhhs.gov/dhsr/hcpr/doc/ExistingProgram_ReapprovalApplication.docx?ver=1.4\"}]",
   "page_url": "https://licensingatlas.com/cna/nc-cna/"
  },
  {
   "page_id": "nd-cna",
   "state": "North Dakota",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "North Dakota Department of Health and Human Services (DHHS), Health Facilities Unit — Nurse Aide Registry. The Unit states its own federal designation: 'The Health Facilities Unit is designated by the Centers for Medicare and Medicaid Services as the agency responsible for the registration of certified nursing assistants, CNAs. In addition to maintaining the NA registry, the Unit receives and investigates allegations of abuse in long term care facilities.' Testing is contracted out: 'The North Dakota Department of Health and Human Services (DHHS) has approved Headmaster, LLP to provide tests and scoring services for North Dakota nurse aide testing.' The State Board of Nursing neither issues nor holds this credential; the statute gives it a consultation role only — in adopting the rules, 'the department shall consult with the state board of nursing and other key stakeholders' (N.D.C.C. 23-44-02(2)).",
   "board_url": "https://www.hhs.nd.gov/health/health-facilities-unit/nurse-aide-registry",
   "application_url": "https://services.ndhhs.gov/nurseaide/",
   "renewal_cycle": "Every 24 months for the certified nurse aide category, and the renewal test is employment — not coursework and not a fee. 'Registry status is limited to twenty-four months. Upon receipt of a completed certified nurse aide renewal application, and verification of employment within the immediate past twenty-four months, the certified nurse aide registry status will be updated to indicate current status' (33-43-01-11(1)(d)). The work threshold is the federal one: 'A certified nurse aide who has not performed at least eight hours of nursing or nursing-related services for pay within a continuous twenty-four-month period shall complete a department-approved training and competency evaluation program or a department-approved competency evaluation to renew current registry status' (33-43-01-11(1)(e)). Notice, and why your address matters: 'Initial CNA certification is two years; renewal is required approximately every two years... Renewal notices will be mailed 60 days before the renewal date to the last known address on file with the Registry', and 'The North Dakota Department of Health and Human Services (DHHS) must be kept informed of your current address.' Renewal is filed through the Department's online registry services; paper applications are not processed. The date is rolling for CNAs and fixed for everyone else — this is the North Dakota detail most often stated wrongly. The Department: 'Any category coupled with a Certified Nurse Aide has a flexible expiration date based on the CNA's last day worked. Initial application date flexible but renewal will be September 30 for Nurse Aide, Home Health Aide, Medication Aide 1 and Medication Aide 2 unless coupled with Certified Nurse Aide.' So a nurse aide, home health aide or medication assistant who is also a CNA renews on the CNA's rolling date; one who is not renews every second September 30, with the $25 fee.",
   "ce_hours": "None is published as a condition of keeping certified nurse aide registry status in North Dakota. What the rule asks for at renewal is a completed application and 'verification of employment within the immediate past twenty-four months' (33-43-01-11(1)(d)), with the eight-hours-of-paid-work floor at 33-43-01-11(1)(e); no continuing education, in-service total or course requirement appears anywhere in the renewal provision. Sources checked and found not to impose continuing education on the aide: N.D.C.C. ch. 23-44 in full, N.D. Admin. Code ch. 33-43-01 in full (all 26 sections), the Department's Certified Nurse Aide Information page, its Nurse Aide Registry page, its Nurse Aide Training and Competency Evaluation Program page, its Nurse Aide Training Program Application for Approval (April 2026), and the state-linked North Dakota Nurse Aide Candidate Handbook. One adjacent requirement is easy to misread as continuing education and is not: the nurse aide category — a different registry category from the certified nurse aide — must file 'verification of competence within the past twelve months' with its $25 renewal (33-43-01-11(3)(d)). That is a competency attestation on a different credential, not CE, and it does not apply to CNAs.",
   "exam": "Two parts, both required: a multiple-choice knowledge test (with an audio version available) and a manual skill test. The rule sets the shape — the competency evaluation must 'allow a nurse aide the option of establishing competency through written or oral and manual skills examination', must draw 'from a pool of test questions, only a portion of which may be utilized in any one examination', and 'must include a demonstration of the randomly selected tasks the individual will be expected to perform' (33-43-01-05(1)). Knowledge test, as published in the state-linked candidate handbook: 'The Knowledge Exam consists of 72 multiple-choice questions. Questions are selected from subject areas based on the DHHS-approved North Dakota test plan.' You get 'ninety (90) minutes to complete the 72-question Knowledge/Audio Exam', with a warning at 15 minutes remaining, and 'You must have a 75% or better score to pass the knowledge portion of the exam.' The published subject-area counts add to the 72: Basic Nursing Skills 11, Care Impaired 5, Communication and Interpersonal Skills 6, Data Collection 3, Disease Process 5, Growth & Development Across the Ages 2, Infection Control 5, Mental Health 4, Personal Care 6, Resident Rights 6, Role and Responsibility 11, Safety 8. Testing is on computers at every site. An audio version is 'offered electronically only', must be requested before the testing fee is paid, and 'There is an additional charge for an audio exam' — the handbook does not print that amount. Two North Dakota-specific rules on what you may bring: 'You may bring a basic calculator. You may not use a cell phone or computer calculator', and, at the Department's direction, 'foreign translation dictionaries (either paper or electronic format), translating devices, or non-approved language translators are not allowed.' Skill test: watched by an RN Test Observer. 'Each of your randomly selected three (3) or four (4) tasks will have scenarios associated with them', and 'You will be allowed thirty (30) minutes to complete your tasks.' The pass standard is step-level: 'To pass the Skill Test, you must correctly perform all key (in bold font) steps and 80% of all non-key steps on each task assigned.' Your first task is always drawn from three mandatory ones — assisting a resident with a bedpan and measuring and recording output; donning an isolation gown and gloves, emptying a urinary drainage bag, measuring and recording output and doffing the gown and gloves; or perineal care for a female resident on a manikin — each with hand washing embedded and demonstrated at the end. 'You will receive two or three randomly selected tasks' after that, and 'Steps that are only verbalized WILL NOT COUNT.' Attempts: three, then back to school. The rule requires the program to advise a failing candidate of the inadequate areas 'and that the individual has not more than three opportunities to take the competency evaluation', and 'If the individual seeking registration fails the competency evaluation on the third attempt, the individual must enroll in and complete a department-approved certified nurse aide training program... prior to taking the competency evaluation again' (33-43-01-08(3)-(4)). A retest is paid for by the part you failed. Results reach the registry quickly: a record of successful completion 'must be included in the nurse aide registry within fourteen days of the date the individual was found to be competent.'",
   "fees": "The certified nurse aide category is free, and North Dakota says so in the rule: 'An individual seeking initial certified nurse aide registry status or registry renewal as a certified nurse aide on the department's nurse aide registry may not be charged a fee' (33-43-01-11(1)(f)). The Department repeats it on its own registry page — 'Certified Nurse Aide - With Training and Competency or Competency Alone NO Fee' and 'Certified Nurse Aide – NO Fee.' The other registry categories are $25 each, non-refundable: nurse aide $25, home health aide $25, medication assistant I $25, medication assistant II $25, on initial registration and again at renewal (33-43-01-11(2)-(3); Department registry page). The Department is emphatic about the non-refundable part: 'when one check is submitted to pay for ten applicants and one applicant cannot be processed, all fees will be kept.' ⚠ The statute and the rule do not say the same thing about the CNA, and this site reports both rather than picking one. The statute is a flat, mandatory direction with no exception and no ceiling language: 'The department shall collect registration fees of twenty-five dollars per individual under this chapter from the individual or the individual's employer' (N.D.C.C. 23-44-02(4)) — and chapter 23-44 expressly covers certified nurse aides, defining them at 23-44-01(1) and making them one of its four registry categories at 23-44-01(6). The Department's own rule says the opposite for that one category: an individual seeking initial certified nurse aide registry status or renewal 'may not be charged a fee' (N.D. Admin. Code 33-43-01-11(1)(f)), and the Department's published price list prints 'Certified Nurse Aide – NO Fee'. What a certified nurse aide is charged in practice is nothing: the rule and the Department's own price list agree, and they are what the Health Facilities Unit applies. The tension with the statute is recorded here, not resolved. Testing: no candidate fee schedule is published by either the Department or the state-linked handbook, and there is a structural reason — a nurse aide 'employed by or having an offer of employment from a facility' cannot be charged 'for any portion of the competency evaluation program' (33-43-01-05(1)(f)), and the same protection covers the training program including textbooks. Where a fee does appear, it is on the candidate side of a retest: 'If you fail the knowledge and/or skill portion of the exam, you will need to pay for the portion you failed before scheduling a new exam date.' The audio version of the knowledge test carries 'an additional charge' whose amount is not published. Test review: '$25 non-refundable test review deposit fee', with an unusual twist — 'If, after investigation, the review finding is in your favor, you will be refunded the $25 test review deposit. If the finding of the review is not in your favor, the $25 test review deposit will stand.' Not set by the state: tuition at a program you attend without an employment offer; the Department publishes the approved-program list but no prices.",
   "legal_basis": "[{\"citation\": \"N.D. Cent. Code ch. 23-44 (Nurse Aide Registry) — 23-44-01 definitions, 23-44-02 registry and rules, 23-44-03 exemption\", \"what_it_governs\": \"North Dakota's own nurse aide statute. It defines certified nurse aide, home health aide, medication assistant and nurse aide as four registry categories; directs that 'The department shall establish and administer a nurse aide registry' including disciplinary findings and employment eligibility; sets the rulemaking agenda (registry requirements, training and competency, approval of training programs, initial registration and renewal, complaints, and discipline for validated findings), with a duty to 'consult with the state board of nursing and other key stakeholders'; directs that 'The department shall collect registration fees of twenty-five dollars per individual under this chapter from the individual or the individual's employer' — a flat mandatory figure rather than a ceiling, and one that sits in unresolved tension with the Department's own rule barring any fee for certified nurse aide registration and renewal, which the fees field records both ways; excludes licensed health care professionals within their scope, unlicensed assistive persons under ch. 43-12.1 and unpaid volunteers; and exempts school medication administration under 15.1-19-23. The Department links this chapter from both of its nurse aide pages.\", \"url\": \"https://ndlegis.gov/cencode/t23c44.pdf\"}, {\"citation\": \"N.D. Admin. Code art. 33-43, ch. 33-43-01 (Nurse Aide Training, Competency Evaluation, and Registry) — the current chapter\", \"what_it_governs\": \"Everything operational: definitions; the training-program screening duty; the 75-hour certified nurse aide program with its 16-hour pre-contact classroom block and 16 hours of supervised practical training; the separate home health aide and nurse aide training standards; the competency evaluation and who may administer it; approval and withdrawal of program status; the three-attempt limit; what the registry contains and who may see it; initial registration and renewal for each category, including the no-fee rule for certified nurse aides and the $25 fee for the others; supervision and delegation; the medication assistant I and II programs; complaint investigations; discipline and the three tiers of consequence for working on an expired registration; the hearing process; and the one-year petition to remove a neglect finding. Every section carries 'History: Effective July 1, 2011', its content having been carried over unchanged when the chapter was recodified.\", \"url\": \"https://ndlegis.gov/information/acdata/pdf/33-43-01.pdf\"}, {\"citation\": \"N.D. Admin. Code ch. 33-07-06 (Nurse Aide Training, Competency Evaluation, and Registry) — repealed effective March 12, 2026\", \"what_it_governs\": \"Nothing, now — and that is why it is listed. This was the nurse aide chapter for years, and the Administrative Code entry for it consists of a single line: '[Repealed effective March 12, 2026].' Its content moved to article 33-43, chapter 33-43-01. Any material that still cites 33-07-06 for a North Dakota nurse aide requirement is citing a repealed chapter, even where the underlying words are unchanged.\", \"url\": \"https://ndlegis.gov/information/acdata/pdf/33-07-06.pdf\"}, {\"citation\": \"42 CFR Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants)\", \"what_it_governs\": \"The federal frame the North Dakota registry implements: approval of training and competency evaluation programs, the required curriculum and the 16 hours before direct resident contact, the competency evaluation, the registry, the prohibition on charging employed aides, and the pro rata reimbursement duty for aides hired within 12 months of completing a program. The Department links this subpart from both of its nurse aide pages and reproduces the charging and reimbursement provisions verbatim in its program guidance, explaining that 'the program must include the exact wording of the CFR.'\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Headmaster, LLP / D&S Diversified Technologies, LLP (D&SDT-Headmaster), delivering the examination through its TestMaster Universe (TMU) system at nd.tmutest.com. The Department names it on its own Nurse Aide Training and Competency Evaluation Program page under the heading 'Nurse Aide Approved Test Vendors': 'Headmaster - D&S Diversified Technologies, LLP, 625 Barney St Ste A Helena, MT 59602-7853', and the state-linked candidate handbook opens with 'The North Dakota Department of Health and Human Services (DHHS) has approved Headmaster, LLP to provide tests and scoring services for North Dakota nurse aide testing.' The rule keeps administration at arm's length from the employer: 'A certified nurse aide competency evaluation must be administered and evaluated by the department or a department-approved entity that is not a nursing facility licensed by the department', and the skills demonstration 'must be administered and evaluated by a registered nurse with at least one year of experience in providing care for the elderly or chronically ill of any age' (33-43-01-06(1)). Facility staff may proctor the written or oral part only if the Department is satisfied the process is secure from tampering, standardized and scored by an approved organization, and 'Exempt from any scoring by facility personnel' — and the Department 'shall retract the right to proctor nurse aide competency evaluations from facilities in which the department finds any evidence of impropriety.' Vendors are named here because North Dakota names them; nothing on this page rates or recommends any provider.",
   "training_hours": "75 hours minimum for the certified nurse aide category, of which at least 16 hours must be classroom training completed before any hands-on contact with residents, and at least 16 hours must be supervised practical training. The number is in North Dakota's own rule, not merely in agency prose: a nursing-facility worker who is not a licensed nurse or volunteer 'must successfully complete a department-approved certified nurse aide training program consisting of a minimum of seventy-five hours' (N.D. Admin. Code 33-43-01-04(1)). The 16-hour pre-contact block is fixed by subject — communication and interpersonal skills, infection control, safety and emergency procedures including the Heimlich maneuver, promoting residents' independence, and respecting residents' rights — and the Department's program-approval guidance is unusually blunt about how literally it wants that written: 'it has been determined the program must include the exact wording of the CFR.' The rest must be finished 'within four months of the date of first employment in the facility as a nurse aide.' North Dakota publishes no classroom/lab/clinical split of the 75 hours beyond those two 16-hour floors: the Department's Nurse Aide Training Program Application for Approval (April 2026 edition) leaves 'Length of the course in hours', 'Number of hours of classroom instruction', 'Number of hours of supervised practical training' and 'Total number of hours of clinical instruction, if applicable' as blanks for the program to fill in, and states no minimum total of its own. A warning about a number that is easy to misattribute: North Dakota's rules do contain a '40 hours of theory, 8 hours of laboratory, 32 hours of clinical' schedule, but it belongs to the medication assistant II program (33-43-01-15) and is not the nurse aide figure. The home health aide category has its own 75-clock-hour rule with the same two 16-hour floors (33-43-01-04(2)(a)), and the nurse aide category is defined by required topics rather than by hours at all (33-43-01-04(3)).",
   "lapse_rule": "North Dakota is unusually precise about lapse, because the rule sets three tiers by how long the registration has been expired, each with a different consequence (33-43-01-22(4)). Thirty days or less: the Department 'will notify the individual and the individual's employer, if known, that the individual must immediately cease to work until the renewal application process is completed and the individual's registry status becomes current.' More than thirty days to six months: the same stop-work notice goes to the individual and employer and to the state survey agency. More than six months: stop work, and the credential is gone — 'The individual's registry status will no longer be recognized by the department. To obtain current registry status again, the individual must follow the process for initial application for registry status.' Separately, the work test: a certified nurse aide who has not performed at least eight hours of paid nursing or nursing-related services in a continuous 24-month period must complete a department-approved training and competency evaluation program, or a department-approved competency evaluation, to renew (33-43-01-11(1)(e)). Reactivation by examination, and its two conditions: the state-linked handbook explains that 'CNAs who have let their CNA license expire on the North Dakota Nurse Aide Registry may be eligible to reactivate their license by examination (taking both components of the nurse aide competency exam – knowledge and skills)', but only if 'The candidate was previously listed on the North Dakota Certified Nurse Aide Registry' and 'The candidate did not Challenge the exam for initial placement on the North Dakota Registry' — meaning 'The candidate must have completed an NDDHHS-approved certified nurse aide training program and can show proof of training completion.' The application is filed on the state's testing system. A change worth knowing, and a conflict recorded both ways: the handbook states twice that 'Effective July 1, 2024, the option to Challenge the North Dakota Certified Nurse Aide Exam is no longer available' — the route by which someone could reach the registry on the competency evaluation alone, without an approved training program. The rule still describes that route as available in several places, including the statutory definition at N.D.C.C. 23-44-01(1) ('or has successfully completed the requirements of the department-approved competency evaluation program') and 33-43-01-04(1). Both are official; this page reports both and resolves neither. Discipline is a different matter from lapse: validated findings of abuse, neglect, misappropriation of resident property or other misconduct are 'identified in the nurse aide registry within ten days of the validation' and 'Remain on the registry permanently, unless the validation was made in error, the individual was found not guilty in a court of a law, or the department is notified of the nurse aide's death.' Only neglect can be petitioned off, after one year, and the review looks at whether the history shows no pattern (defined as 'two or more occurrences'), whether the neglect was 'a singular occurrence', and whether a criminal-history and mistreatment check comes back clean; a committee of a department staff member, a provider representative and the state ombudsman decides (33-43-01-23(6), 33-43-01-24).",
   "reciprocity": "North Dakota calls it both reciprocity and endorsement, and the rule grants it rather than merely permitting an application: 'Certified nurse aide applicants for the nurse aide registry who submit proof of meeting the requirements of another jurisdiction will be granted reciprocity and entered on the nurse aide registry and may use the title \"certified nurse aide\". The individual must meet North Dakota requirements for active registry status' (33-43-01-09(5)). The registration provision says the same thing in endorsement language and adds the clean-record condition: 'Individuals who have met the requirements for registry listing as a certified nurse aide in other states, have a current registry status, and no validated finding may be endorsed onto the department's registry as a certified nurse aide' (33-43-01-11(1)(c)). Where you file it: the Department's online registry services list 'CNA Endorsement/Reciprocity' among the applications you can submit online, alongside home health aide, nurse aide and medication assistant applications; paper applications are not processed. No fee is stated for a CNA endorsement, and none can be under 33-43-01-11(1)(f), which bars charging a fee for initial certified nurse aide registry status. Transfers the other way: the Department's online services include 'Print CNA Verification — Print a CNA verification letter', and the state-linked handbook adds that 'Anyone may contact the North Dakota Department of Health and Human Services (DHHS) to inquire about their status as a nurse aide, lapsed certification, and certification transfer to or from another state.' Not published, and searched for across the statute, the rule, the Department's three nurse aide pages and the state-linked handbook: any processing time for an endorsement decision, and any route for a person trained out of state who was never placed on any registry.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"North Dakota Health and Human Services — Certified Nurse Aide Information. Establishes the Health Facilities Unit's CMS designation 'as the agency responsible for the registration of certified nursing assistants, CNAs', its abuse-investigation role, 'There are over 17,750 people registered to practice as certified nurse aides in the state of North Dakota', that the Unit 'reviews and approves the certified nurse aide training programs throughout the state', the links to the approved-program list and the state-linked candidate handbook, the registry email address, and the regulatory-code list (Century Code ch. 23-44, Administrative Code ch. 33-43-01, and 42 CFR 483 Subpart D).\", \"url\": \"https://www.hhs.nd.gov/health/health-facilities-unit/certified-nurse-aide-information\"}, {\"label\": \"North Dakota Health and Human Services — Nurse Aide Registry and Certified Nurse Aide. Establishes the fee structure across all registry categories in the Department's own words ('Certified Nurse Aide - With Training and Competency or Competency Alone NO Fee'; '$25 Non-Refundable Fee' for nurse aide, home health aide, medication aide I and medication aide II), the non-refundable batch-payment rule, 'Health Facilities does not process paper applications' and 'The Unit does not process paper applications', the expiration and renewal rules ('Any category paired with a CNA has a flexible expiration date based on the CNA's last day worked. Initial application dates are flexible, but renewal occurs on September 30 for NA, HHA, MA I, and MA II, unless the category is coupled with a CNA'), and the medication assistant entry rules ('You must be a Nurse Aide (NA) or Certified Nurse Aide (CNA) to be an MA I. Only a CNA can be an MA II').\", \"url\": \"https://www.hhs.nd.gov/health/health-facilities-unit/nurse-aide-registry\"}, {\"label\": \"North Dakota Health and Human Services — Nurse Aide Training and Competency Evaluation Program. Establishes the Department's program-approval role, the curriculum wording requirements ('it has been determined the program must include the exact wording of the CFR') and the 16 hours of training required 'prior to any direct resident contact' with the five named topics, the required basic nursing, personal care, mental health, cognitive-impairment, restorative and residents'-rights content, the verbatim federal prohibition on charging employed nurse aides and the 12-month pro rata reimbursement rule, and the approved test vendor: 'Headmaster - D&S Diversified Technologies, LLP.'\", \"url\": \"https://www.hhs.nd.gov/health/health-facilities-unit/nurse-aide-training-and\"}, {\"label\": \"North Dakota Health and Human Services — Nurse Aide Training Program Application for Approval (form dated 04-2026). Establishes what the Department asks a program to submit — course curriculum with subjects, time per subject, time in supervised practical training and when first direct resident contact occurs — and that the hours fields ('Length of the course in hours', 'Number of hours of classroom instruction', 'Number of hours of supervised practical training', 'Total number of hours of clinical instruction, if applicable') are blanks the program fills in rather than state-set minimums. Also establishes the facility-proctoring section, the requirement to explain how candidates are told they have 'up to three opportunities to take the evaluation', and the naming of Headmaster as the competency evaluation program.\", \"url\": \"https://www.hhs.nd.gov/sites/default/files/documents/DOH%20Legacy/HF/NATP/na-training-program-application.pdf\"}, {\"label\": \"N.D. Cent. Code ch. 23-44 (Nurse Aide Registry), North Dakota Legislative Branch. Establishes the four registry categories and their definitions, the duty to establish and administer the registry with disciplinary findings and employment eligibility, the rulemaking agenda and the duty to consult the state board of nursing, the twenty-five dollar registration fee 'from the individual or the individual's employer', the three statutory exclusions (licensed health care professionals in scope, unlicensed assistive persons under ch. 43-12.1, unpaid volunteers), and the school medication-administration exemption at 23-44-03.\", \"url\": \"https://ndlegis.gov/cencode/t23c44.pdf\"}, {\"label\": \"N.D. Admin. Code ch. 33-43-01 (Nurse Aide Training, Competency Evaluation, and Registry), North Dakota Legislative Branch — the chapter the Department itself links. Establishes the 75-hour minimum and the two 16-hour floors, the four-month completion and four-month employment windows, the qualified-instructor definitions, the no-charge rules, the competency evaluation structure and its administration away from the employing facility, the three-attempt limit and the retraining consequence, the fourteen-day registry entry deadline, the registry contents and disclosure rules, reciprocity/endorsement for out-of-state certified nurse aides, the no-fee rule for certified nurse aide registration and renewal against the $25 fee for the other categories, the September 30 renewal date for the non-CNA categories, the 24-month registry term and the eight-hours-of-paid-work renewal test, the medication assistant I and II programs (including the 40-hours-theory/8-hours-laboratory/32-hours-clinical schedule that belongs to MA II and not to the CNA), the grounds for discipline, the three tiers of consequence for working on an expired registration, the hearing process, and the neglect-finding removal petition.\", \"url\": \"https://ndlegis.gov/information/acdata/pdf/33-43-01.pdf\"}, {\"label\": \"N.D. Admin. Code ch. 33-07-06, North Dakota Legislative Branch — the repealed predecessor chapter, whose entire published text now reads 'CHAPTER 33-07-06 NURSE AIDE TRAINING, COMPETENCY EVALUATION, AND REGISTRY [Repealed effective March 12, 2026]'. Cited only to fix the repeal date and to mark the citation as dead.\", \"url\": \"https://ndlegis.gov/information/acdata/pdf/33-07-06.pdf\"}, {\"label\": \"North Dakota Nurse Aide Candidate Handbook (effective for testing July 1, 2024; updated April 2025; Version 6) — the booklet the Department links from its Certified Nurse Aide Information page as 'Candidate Handbook'. Establishes 'The North Dakota Department of Health and Human Services (DHHS) has approved Headmaster, LLP to provide tests and scoring services'; 'To qualify for certification as a nurse aide in North Dakota, exam candidates must be registered, complete approved training, pass both parts of the exam, and meet all other requirements'; the two-year term and the 60-day mailed renewal notice; 'Effective July 1, 2024, the option to Challenge the North Dakota Certified Nurse Aide Exam is no longer available'; the Reactivation by Exam conditions; the 72-question, 90-minute, 75%-to-pass knowledge exam and its subject-area counts; the calculator and translation-dictionary rules; the audio version and its unstated additional charge; the 30-minute, three-or-four-task skill test with its all-key-steps-plus-80% standard and its three mandatory first tasks; the pay-for-the-part-you-failed retest rule; and the $25 refundable-if-you-win test review deposit.\", \"url\": \"https://hdmaster.com/testing/cnatesting/ndakota/ndformpages/ndforms/ND%20CandidateHandbook.pdf\"}, {\"label\": \"North Dakota Nurse Aide Background Questions / Parent-Guardian Signature form, on the state-approved test vendor's North Dakota page. Establishes the six background questions every North Dakota candidate must answer and the parent or guardian signature block used for candidates who are minors.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/ndakota/ndformpages/ndforms/Consent%20Form.pdf\"}, {\"label\": \"D&S Diversified Technologies / Headmaster — North Dakota CNA page, the vendor page the Department links as 'D&S - North Dakota'. Establishes the state-specific document set: the candidate handbook (effective 4-2025), skills test and electronic knowledge test instructions, the Test Site List Form 1700ND, mock skills, the recording form, and the North Dakota TMU login at nd.tmutest.com.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/ndakota/ND_CNA_Home.htm\"}, {\"label\": \"North Dakota Nurse Aide Registry Online Services. The Department's own registry hub: online applications including 'CNA Endorsement/Reciprocity', home health aide, nurse aide and medication assistant; 'Registration Verifications — To look up a registrants information, please click the \\\"Verify a registration\\\" link below'; renewals; address and name changes; 'Print your registration card'; 'Print a CNA verification letter'; facility incident reporting; and 'View the validated abuse list'.\", \"url\": \"https://services.ndhhs.gov/nurseaide/\"}]",
   "page_url": "https://licensingatlas.com/cna/nd-cna/"
  },
  {
   "page_id": "ne-cna",
   "state": "Nebraska",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Nebraska Department of Health and Human Services, Division of Public Health, Licensure Unit — Office of Nursing Support (Nurse Aide Registry). No board of nursing issues this status: the registry itself is a Medicaid-side creation, and 471 Nebraska Administrative Code 12 provides that 'A registry of nurse aides is established and maintained by the State for the purpose of providing a central data bank of individuals who are eligible to function as nurse aides in certified facilities. The State Medicaid agency contracts with the State Survey and Certification agency to operate and maintain the registry.'",
   "board_url": "https://dhhs.ne.gov/licensure/pages/nurse-aide.aspx",
   "application_url": "https://dhhs.ne.gov/licensure/pages/nurse-aide.aspx",
   "renewal_cycle": "There is no renewal application, no renewal fee and no expiry date — there is only a rolling 24-month work test. The Department's status table says 'Expiration dates - none noted unless lapsed or ineligible', and defines Active status as 'passed exams and/or has worked as nurse aide in the past 2 years.' The rule it states for keeping that status is one sentence: 'Staying Active on the Registry – Must work as a nurse aide in a paid position within 24 months of last date of previous employment.' It repeats the point in its FAQ: 'To stay active on the registry, you must have worked as a nurse aide in a paid position within the past two years in an approved employer setting.' Where the work counts is a published, closed list — the Department's 'Approved Employer Settings for Nurse Aide to stay active' names ambulatory surgical center, assisted-living facility, critical access hospital, general acute hospital, health clinic, licensed home health agency, hospice, hospital, intermediate care facility, intermediate care facility for developmental disabilities, long term care hospital, nursing facility, psychiatric or mental hospital, rehabilitation hospital, skilled nursing facility, and — the newest addition — 'Community-Based Developmental Disabilities Service providers', with the footnote 'This does not include the Home and Community Based Services Waiver.' The same document dates both changes: 'Effective August 24, 2017, Nebraska law states that the work setting is to be a health care setting licensed by the State of Nebraska' and 'Effective September 3, 2025, certified DD Community-Based Developmental Disabilities service providers were added to approved employer settings.' There is no notice mailed before a lapse. The employer, not the aide, files the paperwork that keeps the record straight: the facility submits a Registry Form 'upon hire of a nurse aide' and an End of Employment/Termination Form 'when nurse aide no longer works for them', and the Department publishes a weekly roster of nurse aides by employer, 'updated weekly on Friday', which is 'over 1,100 pages'.",
   "ce_hours": "None is published as a condition of Nebraska registry status. The Department's Nurse Aide and Nurse Aide Requirements pages describe staying active purely in terms of paid work in an approved setting, and neither names a continuing-education, refresher or annual in-service requirement running to the aide. Neb. Rev. Stat. §§ 71-6038 to 71-6042 impose none, and 172 NAC 108 imposes none — the chapter's only recurring obligations run to training programmes (five working days' notice of each course, attendance records kept 'for a minimum of 2 years', periodic on-site review) and to testing entities (quality assurance and data reporting), not to individual aides. Sources checked: the Department's Nurse Aide page, its Nurse Aide Requirements page, its Nebraska Abuse/Neglect/Misappropriation Training instruction sheet, its Approved Employer Settings list, 172 NAC 108 in full, the nurse aide sections of 471 NAC 12, and Neb. Rev. Stat. §§ 71-6038 through 71-6042. The one education item that is not optional is a one-time one, not an annual one: 'All applicants for the Nebraska Nurse Aide Registry are required to complete a one (1) time, one (1) hour training on Nebraska's abuse, neglect, and misappropriation.' If you take a Nebraska nurse aide course it is built in — 'the one (1) hour training on abuse, neglect, and misappropriation is included as part of your training.' Everyone else — nursing students, foreign-trained nurses, inactive or lapsed nurses, and every aide arriving from another state — must obtain it separately, by employer orientation, online, or in person at a named college, and 'The Nebraska Nurse Aide Registry must receive proof of your completion of the training before your nurse aide registration number is issued.' Separate federal rules oblige nursing facilities to provide in-service training to their staff; that is a facility duty and no Nebraska source read makes it a condition of an aide's registry listing.",
   "exam": "Two parts, both required, both given by an approved testing entity rather than a national vendor. The numbers come from the Department's own page: 'Written/oral exam – consists of 50 multiple-choice questions', 'Passing grade is 70 percent or greater', 'Takes approximately three weeks to be made active on registry', and 'An individual has a total of three opportunities to pass each exam. If an individual does not pass the exam after three tries, he/she must retake the 75-hour nurse aide course.' Skills: 'Skills exam – consists of a demonstration of six skills. Passing score is 70 percent or greater on each skill. Skills may have one or more mandatory steps. These steps must be performed correctly in order to pass that skill. If any of the six skills are failed, the individual fails the skills exam. The individual has a total of three opportunities to pass the skills exam. If the skills exam is not passed after three tries, he or she must retake the 75-hour nurse aide training course.' How the exam must be built, from 172 NAC 108-006.01: the written or oral portion must 'Address each course requirement listed in section 004', 'Be developed from a pool of questions, only a portion of which is used in any one examination', 'Use a system that prevents disclosure of both the question pool and the individual competency evaluations', and — if oral — 'be read from a prepared text in a neutral manner', and must be 'tested for reliability and validity using nationally recognized standards.' The skills portion must address each personal care skill in the curriculum and 'Consist of demonstration of randomly selected items drawn from a pool of tasks generally performed by nurse aides.' Results and timing: 'A score of pass must be achieved for both the written, oral, and skills demonstration parts of the test. The competency testing entity will inform the nurse aide of the test score within 5 calendar days of the completion of the test and will inform the nurse aide registry of the nurse aide's scores within 14 calendar days after the test is completed' (172 NAC 108-006.03). On a failure, 'Any person who does not complete the evaluation satisfactorily will be advised in writing within 5 calendar days after the test is scored of the areas which the person did not pass and that the person has 3 opportunities to take the evaluation' (172 NAC 108-006.04). Candidates are told in advance 'that a record of the successful completion of the examination will be included in the state's nurse aide registry' (172 NAC 108-006.02). No state exam fee is published — see the fee breakdown below.",
   "fees": "Nebraska charges nothing to get on or stay on the nurse aide registry, and says so twice. The Department's Nurse Aide page states 'Fees – there are none for nurse aides' and, on the name-change form line, 'There is no charge for nurse aides changing their name.' The Medicaid rule that created the registry makes it a standing prohibition rather than a current price: 'No monetary charges related to registration of individuals on the registry are imposed' (471 NAC 12-013.04(B)(iv), 06-26-2021 edition). Interstate endorsement is free as well, and out-of-state verification is free in the other direction too: 'Nebraska does not charge a fee to complete this form.' The one state fee anywhere on this pathway is optional and comes before it: the 'Preliminary Application Conviction Review' lets someone with a criminal conviction ask in advance whether it would be disqualifying, and 'The fee is $100 for each license type for which you are requesting a review.' Not set or collected by the state: tuition for the 75-hour course, which each approved training entity sets for itself — the Department publishes the list of approved entities and their phone numbers but no prices — and the fee, if any, charged by an approved provider for the competency evaluation or for re-competency testing. Neither the Department's nurse aide pages, 172 NAC 108, 471 NAC 12 nor Neb. Rev. Stat. §§ 71-6038 to 71-6042 publishes an examination fee or a re-test fee, and all four were checked. Remember that in most cases the training cost is not yours to carry at all: a facility that employs you or has offered you a job when training starts 'is required to pay the full cost of the training program', and one that hires you within twelve months of completion owes you a prorated refund.",
   "legal_basis": "[{\"citation\": \"Neb. Rev. Stat. §§ 71-6038 to 71-6042 (Nursing Homes — Nursing Assistants and Paid Dining Assistants; Training Requirements)\", \"what_it_governs\": \"The whole Nebraska nurse aide scheme: the definitions including 'nurse aide' and, since 2025, 'service provider' (§ 71-6038); the three qualifications and the 120-day post-hire training deadline, the 75-hour and 20-hour course floors, the bar on disciplined nurses acting as aides, the nullity of a registration on becoming a licensed nurse, and the one-year petition to remove a finding of conviction (§ 71-6039); the paid dining assistant provisions (§§ 71-6039.01 to 71-6039.05); the Department's duty to approve all courses and materials (§ 71-6040); its rulemaking duty, which must be 'consistent with federal requirements developed by the United States Department of Health and Human Services' (§ 71-6041); and enforcement against the nursing home's license by the chief medical officer (§ 71-6042).\", \"url\": \"https://nebraskalegislature.gov/laws/statutes.php?statute=71-6039\"}, {\"citation\": \"Neb. Rev. Stat. § 71-6039, as amended by Laws 2025, LB42, § 2 (and § 71-6038 as amended by Laws 2025, LB42, § 1)\", \"what_it_governs\": \"The 2025 extension of the nurse aide requirement beyond licensed facilities to 'a service provider under the medicaid comprehensive developmental disabilities waiver for services as defined in section 71-6501', with 'Service provider' newly defined at § 71-6038(6) as 'a person certified by the department to provide developmental disabilities services'. This amendment is in the Legislature's live text of both sections but is absent from the Department's own published statute booklet, which is dated 2019; the Department's approved-employer list does reflect it, recording that 'Effective September 3, 2025, certified DD Community-Based Developmental Disabilities service providers were added to approved employer settings.'\", \"url\": \"https://nebraskalegislature.gov/laws/statutes.php?statute=71-6038\"}, {\"citation\": \"172 Neb. Admin. Code ch. 108 — Approval of Training Programs and Qualifications for Nurse Aides in Nursing Homes, effective 09-24-2022\", \"what_it_governs\": \"The operating rule for this credential: what it takes to act as a nurse aide (108-003.01); findings of conviction on the registry (108-003.02); the 75 clock hours with at least 16 hours of supervised practical training, the 16 pre-contact hours and the full seven-part curriculum (108-004.01); the ICF/IID course at 15 + 5 hours plus the abuse-reporting hour (108-004.02); the requirement that a Nebraska-licensed registered nurse administer the course (108-004.03); course completion documentation (108-004.04 to .05); the programme approval application, its 30-day lead time, continuing approval, on-site inspection, two-year attendance records and revocation (108-005); and the competency evaluation — who may give it, its written/oral and skills structure, the pass standard, the 5-day and 14-day reporting deadlines, the three attempts, and the quality-assurance and data duties on any testing contractor (108-006).\", \"url\": \"https://rules.nebraska.gov/rules?agencyId=37&titleId=101\"}, {\"citation\": \"471 Neb. Admin. Code ch. 12 — Nursing Facility Regulations, § 013 (Nurse Aides in Nursing Facilities)\", \"what_it_governs\": \"The Medicaid-side rule that creates the registry and states who runs it (013.04(A)), who may be listed and the prohibition on charging for registration (013.04(B)), what the registry record contains including the 24-month ineligibility documentation (013.04(C)), the neglect-finding petition, review and permanence rules (013.04(D)), the facility's duty to check the Nebraska registry and every other state registry before letting someone work (013.02), and the investigation, notice, hearing and reporting process for abuse, neglect and misappropriation findings (013.05). The edition read was the one stamped effective 06-26-2021 in the State of Nebraska document repository; the state rules index lists chapter 12 as effective 6/6/2022, and that later edition was not read as of August 16, 2026. Everything attributed to 471 NAC 12 on this page is attributed to the 06-26-2021 edition on its face.\", \"url\": \"https://rules.nebraska.gov/rules?agencyId=37&titleId=226\"}, {\"citation\": \"42 CFR Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants)\", \"what_it_governs\": \"The federal frame Nebraska's scheme sits inside and the source the Department links from its own Nurse Aide page under the heading 'Statutes'. 172 NAC 108-001 states that the Nebraska rules 'are consistent with federal requirements at 42 CFR § 483, Subpart D, as it existed on the effective date of these regulations', and 172 NAC 108-006.01 requires both exam portions to 'Meet all other requirements set forth in 42 CFR § 483, Subpart D.' The federal prohibition on charging an employed nurse aide for training, quoted in Nebraska's Medicaid Provider Bulletin 07-07, is at 42 CFR 483.152(c).\", \"url\": \"https://www.ecfr.gov/current/title-42/part-483#subpart-D\"}, {\"citation\": \"Neb. Rev. Stat. § 28-372 (Report of abuse, neglect, or exploitation; required) and § 28-711 (Child subjected to abuse or neglect; report)\", \"what_it_governs\": \"The mandatory-reporting duties a nurse aide carries and the reason Nebraska bolts a dedicated abuse/neglect hour onto every route into the registry. Neb. Rev. Stat. § 71-6039(3) requires that approved courses 'include instruction on the responsibility of each nurse aide to report suspected abuse or neglect pursuant to sections 28-372 and 28-711', and the Department's own instruction sheet states that its one-hour training 'is based on the requirement in Neb. Rev. Stat. §28-372 and Neb. Rev. Stat. §71-6039.' § 28-372 names 'nurse aide' expressly in its list of mandatory reporters.\", \"url\": \"https://nebraskalegislature.gov/laws/statutes.php?statute=28-372\"}]",
   "exam_vendor": "There is no single statewide testing vendor, and that is the defining fact about Nebraska's exam. The regulation gives the Department three options and it uses more than one: 'The Department may administer and evaluate competency evaluations; contract for the administration and evaluation of competency evaluations; or request applications for approval to administer and evaluate competency evaluations' (172 NAC 108-006). In practice the tests are given by approved training entities and post-secondary providers around the state; for people coming back from a lapsed status the Department publishes a named list, 'Post-Secondary Education Providers Approved for Nurse Aide Re-Competency Testing' (updated 10/28/24). It has eleven entries and no others: Central Community College at Columbus, Grand Island and Hastings; Mid-Plains Community College at McCook and North Platte; Northeast Community College at Norfolk; Clarkson College and Nebraska Methodist College at Omaha; Quality Career Pathways at Omaha; the Nebraska Health Care Learning Center (Lincoln, Omaha and various locations); and Providence Health Career Institute, LLC (Lincoln and various locations). The list also flags which of them run more than the test: '*Also has a Refresher Course for Nurse Aides' and '# Offers an on-line abuse in-service'. ⚠ Do not read the other Department list as this one. Nebraska publishes a separate, much longer roster, 'All Training Entities Approved to Teach Nebraska's 75-Hour Nurse Aide Course by City' (Revised 7-21-26), which includes high schools, hospitals, veterans homes, nursing facilities and institutions such as Bryan College of Health Sciences in Lincoln. Approval to teach the 75-hour course is not approval to give the re-competency test, and the eleven names above are the only ones the Department publishes for re-competency testing. Who is shut out: 'Skilled nursing facilities that participate in Medicare and nursing facilities that participate in Medicaid are not eligible to administer and evaluate competency evaluations', and 'A nurse aide course instructor cannot teach a student in the nurse aide course and administer the competency evaluation to the same student.' Who grades the skills test: the skills portion must 'be performed in a setting comparable to the setting in which the nurse aide will operate and be administered and evaluated by a registered nurse with at least one year's experience in providing care for the elderly or the chronically ill of any age' (172 NAC 108-006.01(B)(iii)). Nebraska's own quality controls on whoever gives the test are written into the rule: a standard quality assurance programme, exams 'linked to the nurse aide job analysis and supported by psychometric data', and reporting of pass/fail rates, item analysis, candidate satisfaction, ADA accommodations and rater-reliability data on request (172 NAC 108-006.06).",
   "training_hours": "75 clock hours minimum for nursing home work, of which at least 16 hours must be supervised practical training and at least 16 hours must come before you ever touch a resident. The regulation is the precise source: courses 'must be given by a single sponsor or organization and include, at a minimum, 75 clock hours of instruction, including at least 16 hours of supervised practical training. In addition, the course must include at least 1 hour of instruction on the responsibility of each nurse aide to report suspected abuse or neglect' (172 NAC 108-004.01). Note the words 'In addition' — on the face of the regulation the abuse/neglect hour sits on top of the 75, and the Department's Nurse Aide page likewise lists '75 hours of training' and 'one hour of Nebraska-specific abuse/neglect/misappropriation training' as two separate qualification bullets. No Nebraska source read states a combined total, so none is given here. The pre-contact 16 hours are a separate 16 from the practical-training 16: the same regulation requires 'At least 16 hours of training in the following areas prior to any direct contact with residents: (i) Communication and interpersonal skills; (ii) Infection control; (iii) Safety and emergency procedures, including emergency measures for choking; (iv) Promoting residents' independence; (v) Respecting residents' rights.' The statute sets the same floor without the breakdown: courses 'shall be no less than seventy-five hours in duration' for all nursing homes other than ICF/IIDs (Neb. Rev. Stat. § 71-6039(4)), and § 71-6039(5) adds that nothing 'shall prohibit any facility from exceeding the minimum hourly or training requirements.' The ICF/IID track is different and the three sources phrase it differently — statute 20 hours (15 basic personal care + 5 basic therapeutic and emergency procedure), regulation the same 15 + 5 plus 'at least 1 hour of instruction on the responsibility of each nurse aide to report suspected abuse or neglect', and the Department's web page 'a 21-hour basic resident care course'; all three are given in the license types table without one being picked. What the 75 hours must cover, per 172 NAC 108-004.01(B)-(G): basic nursing skills; personal care skills; mental health and social service needs; care of cognitively impaired residents; basic restorative services; and residents' rights. The Department does not publish a unit-by-unit hour schedule the way some states do — the hours-per-unit figure is supplied by each program in its approval application, which must list 'Units to be covered in the course... and the hours to be spent on each unit' (172 NAC 108-005.01(E)).",
   "lapse_rule": "Two years without paid nurse aide work and the listing goes Lapsed — the Department defines it as 'no record of passing exams or employment in the past 2 years.' The Medicaid rule requires the registry itself to carry 'Documentation of the ineligibility of individuals who have performed no nursing or nursing-related services for a period of 24 consecutive months' (471 NAC 12-013.04(C)(vii), 06-26-2021 edition). Getting back: there is no grace application and no work-history route — you re-test. 'A nurse aide whose status is lapsed may reactivate his or her registration by retaking the written/oral and clinical exams.' The Department's practical instructions: 'contact one of these Post Secondary Education Providers approved to do re-competency testing' — meaning the eleven entities on the Department's re-competency list, which is a different and much shorter list than its roster of entities approved to teach the 75-hour course (see the exam details on this page); 'Completion of both the written and clinical exams may occur on the same day'; and 'It may take three weeks to update your records after successful completion of exams.' You may need to bring proof of your own status — 'If you are retesting, you may need to give them a copy of the screen print of your \"verification of registry\"... The \"verification of registry\" informs the program personnel that you are eligible to retest.' One group cannot re-test at all: 'Nurse aides who took a 30-hour nurse aide course prior to 1989 and were \"grandfathered\" onto the registry are not eligible to retest. The nurse aide is required to take the 75-Hour Nurse Aide Course.' A third status sits below lapsed and is not fixed by testing: 'Ineligible – finding of conviction, abuse, neglect, or misappropriation on record. Not eligible to work in a certified nursing home.' A finding of abuse or misappropriation 'remains on the registry permanently, unless the finding was made in error, the individual was found not guilty in a court of law, or the State is notified of the individual's death'; only neglect findings may be petitioned away, and only if 'The employment and personal history of the nurse aide does not reflect a pattern of abusive behavior or neglect', 'The neglect involved in the original finding was a singular occurrence', and 'More than one year has lapsed since the finding of neglect was added to the nurse aide registry' (471 NAC 12-013.04(D)(i)). Even then the reviewer may require re-training or a rehabilitation programme before removing it, decides within 150 days, and a repeat finding after a removal 'will remain on the registry permanently with no opportunity for review.' Separately, a finding of conviction under 172 NAC 108-003.02 may be petitioned away 'at any time after one year has elapsed' (Neb. Rev. Stat. § 71-6039(2)(c)).",
   "reciprocity": "Nebraska calls it interstate endorsement and runs it on a single one-page form with no fee. The Department's condition is stated first as a bar: 'If you are a nurse aide in another state and want to work in Nebraska, you must be active on the Nebraska Nurse Aide Registry before you are eligible to work in a certified nursing facility.' Four things are required, in the form's own words: 'Nebraska requires you be active in the State you are seeking reciprocity from, completed a minimum 75-hour nurse aide training program, have passing scores on written and clinical exams, and have nurse aide employment in the last 24 months (if you have not tested in the last 24 months.)' a fifth is added separately and catches everyone: 'All nurse aides coming into Nebraska from another state must also have Nebraska's one-hour in-service on reporting abuse and neglect. This in-service may be obtained from your first Nebraska nursing home employer or it can be obtained at some of the community colleges or on-line. You will not be made active on the Nebraska Nurse Aide Registry until you have completed this in-service.' The disqualifier most applicants miss: 'If you have ever been active on the Nebraska Nurse Aide Registry, you are not eligible to apply by Interstate Endorsement. You will need to either retest in Nebraska or provide Employment Verification.' Timing and checks: the Department's Nurse Aide page says 'it may take us up to 30 days to process a completed form', and the form itself puts the same period a little differently — 'We process applications in order received and it can take up to 30 days to process your application after receipt. If your application is not complete, we will send the application back to you with a deficiency letter.' On checks: 'Nebraska will contact the Nurse Aide Registry in the state in which you received your training and any other states in which you have worked as a nurse aide.' Facilities must run the same multi-state check independently — 'Before allowing an individual to serve as a nurse aide, a facility must seek information from every State nurse aide registry the facility believes will include information on the individual' (471 NAC 12-013.02(B), 06-26-2021 edition). Leaving Nebraska: 'contact the Nurse Aide Registry in the state where you plan to work. Each state has its own reciprocity or endorsement requirements... Nebraska does not have forms required by other states. Contact that state to obtain their forms. We do not issue physical certificates or licensure cards for nurse aides. You can obtain a verification from the registry. Nebraska does not charge a fee to complete this form.' A practical quirk the Department publishes: 'If you are faxing your application to us, make sure it is on white paper. (Colored paper does not fax well.)'",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Nebraska DHHS — Nurse Aide (the registry landing page). Establishes the six-item qualification list including 'At least 16 years of age', the moral-turpitude gloss, 'Successfully complete a minimum of 75 hours of training approved by the State of Nebraska or a 21-hour basic resident care course for intermediate care facilities for the developmentally disabled' and the separate one-hour Nebraska abuse/neglect/misappropriation bullet; the registry status definitions Active / Lapsed / Ineligible and 'Expiration dates - none noted unless lapsed or ineligible'; 'Application – there is none for nurse aides' and 'Fees – there are none for nurse aides'; the $100 Preliminary Application Conviction Review; the Generate Wallet Card instruction; the exam structure ('50 multiple-choice questions', 70 percent, 'a demonstration of six skills', three opportunities, retake the 75-hour course); the lift-age FAQ citing DOL Field Assistance Bulletin No. 2011-3; the training-program waiver; the transferring-in instruction 'Complete the Interstate Endorsement form. Note: it may take us up to 30 days to process a completed form' and the transferring-out instructions including 'We do not issue physical certificates or licensure cards for nurse aides' and 'Nebraska does not charge a fee to complete this form'; the employer forms and the weekly 1,100-page roster; and the Regulations and Statutes links to 172 NAC 108, 471 NAC 12 and the Department's statute booklet.\", \"url\": \"https://dhhs.ne.gov/licensure/pages/nurse-aide.aspx\"}, {\"label\": \"Nebraska DHHS — Nurse Aide Requirements. Establishes 'Staying Active on the Registry – Must work as a nurse aide in a paid position within 24 months of last date of previous employment'; the reactivation rule 'A nurse aide whose status is lapsed may reactivate his or her registration by retaking the written/oral and clinical exams', with same-day testing and the three-week records update; the bar on re-testing for pre-1989 30-hour grandfathered aides; and the three alternative routes onto the registry for nursing students, foreign-trained nurses (including the CGFNS Credentials Evaluation Service Professional Report) and inactive or lapsed RNs and LPNs.\", \"url\": \"https://dhhs.ne.gov/licensure/Pages/Nurse-Aide-Requirements.aspx\"}, {\"label\": \"Nebraska DHHS — Application for Nebraska Nurse Aide Registry by Interstate Endorsement (form, Word original dated 7-18-2022). Establishes the four endorsement conditions ('active in the State you are seeking reciprocity from, completed a minimum 75-hour nurse aide training program, have passing scores on written and clinical exams, and have nurse aide employment in the last 24 months'), the disqualifier for anyone ever active on the Nebraska registry, the added one-hour Nebraska abuse/neglect in-service, the form's own processing statement ('We process applications in order received and it can take up to 30 days to process your application after receipt' — note this is the form's wording; the shorter 'it may take us up to 30 days to process a completed form' is the Department's Nurse Aide page, not this document), the deficiency-letter procedure, 'we will issue your registration (license) number and place you on the website where employers can find you', 'We do not issue licensure cards for Nurse Aides' with 'we do not send you any notification that we have issued your registration number', and the website 'updated every day about 8:00 am'.\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/NAInterstateEndorsementApp.pdf\"}, {\"label\": \"Nebraska DHHS — Approved Employer Settings for Nurse Aide to stay active. Establishes the closed list of sixteen employer settings that keep a listing Active, the statutory hook ('Effective August 24, 2017, Nebraska law states that the work setting is to be a health care setting licensed by the State of Nebraska. The actual settings are identified in the statute Neb. Rev. Stat. §. 71-6039'), the 2025 addition ('Effective September 3, 2025, certified DD Community-Based Developmental Disabilities service providers were added to approved employer settings'), and the exclusion footnote 'This does not include the Home and Community Based Services Waiver.'\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/NurseAideApprovedEmpSettings.pdf\"}, {\"label\": \"Nebraska DHHS — Nebraska Abuse/Neglect/Misappropriation Training (instruction sheet). Establishes 'All applicants for the Nebraska Nurse Aide Registry are required to complete a one (1) time, one (1) hour training', its statutory basis in Neb. Rev. Stat. §§ 28-372 and 71-6039, the rule that Nebraska course-takers get it inside their course, the three delivery methods (employer orientation, online, in-person college class) with the named providers, and 'The Nebraska Nurse Aide Registry must receive proof of your completion of the training before your nurse aide registration number is issued.'\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/Abuseneglect.pdf\"}, {\"label\": \"Nebraska DHHS — Post-Secondary Education Providers Approved for Nurse Aide Re-Competency Testing (updated 10/28/24). Establishes the named list of entities that give the re-competency exams, the note that some also run a 'Refresher Course for Nurse Aides' and some offer the online abuse in-service, and the instruction to bring a printed 'verification of registry' from the state lookup to prove eligibility to retest.\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/NARecompetencyCollegeList.pdf\"}, {\"label\": \"Nebraska DHHS — All Training Entities Approved to Teach Nebraska's 75-Hour Nurse Aide Course by City (Revised 7-21-26). Establishes the Department's own name for the course, and the three-page approved-provider list by city and county covering community colleges, high schools, hospitals, veterans homes and nursing facilities.\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/NurseAideListAppvdTrngSites.pdf\"}, {\"label\": \"Nebraska Legislature — Neb. Rev. Stat. § 71-6039 (live statute text). Establishes the three qualifications, the 120-day post-hire training deadline, the 2025 extension to medicaid comprehensive developmental disabilities waiver service providers (Laws 2025, LB42, § 2), the bar on revoked/suspended/surrendered nurses acting as aides, the nullity of a nurse aide registration on nurse licensure, the one-year petition to remove a finding of conviction, the rule that nursing homes may teach but 'may not conduct the competency evaluation part of the program', the requirement that training be administered by a licensed registered nurse, and the 75-hour and 20-hour (15 + 5) course floors.\", \"url\": \"https://nebraskalegislature.gov/laws/statutes.php?statute=71-6039\"}, {\"label\": \"Nebraska Legislature — Neb. Rev. Stat. § 71-6038 (live statute text). Establishes the definition of 'nurse aide', the exclusion of paid dining assistants and licensed nurses from that definition, and the 2025-added definition '(6) Service provider means a person certified by the department to provide developmental disabilities services' (Laws 2025, LB42, § 1).\", \"url\": \"https://nebraskalegislature.gov/laws/statutes.php?statute=71-6038\"}, {\"label\": \"Nebraska DHHS — 2019 state of Nebraska statutes relating to nursing assistants and paid dining assistants (nursing homes), the booklet the Department publishes and links from its own Nurse Aide page. Reproduces §§ 71-6038 to 71-6042 plus §§ 28-372 and 28-711. Recorded here as a source and as a divergence: its text of §§ 71-6038 and 71-6039 predates Laws 2025, LB42 and therefore lacks both the 'service provider' definition and the extension of the nurse aide requirement to developmental disabilities waiver service providers.\", \"url\": \"https://dhhs.ne.gov/licensure/Documents/NurseAssistantsAndPaidDiningAssistants.pdf\"}, {\"label\": \"State of Nebraska document repository — 172 NAC 108, Approval of Training Programs and Qualifications for Nurse Aides in Nursing Homes, stamped effective 09-24-2022. Establishes 108-003.01 (the three things it takes to act as a nurse aide), 108-003.02 (findings of conviction), 108-004.01 ('at a minimum, 75 clock hours of instruction, including at least 16 hours of supervised practical training. In addition, the course must include at least 1 hour of instruction on the responsibility of each nurse aide to report suspected abuse or neglect', the 16 pre-contact hours and the full curriculum), 108-004.02 (the ICF/IID 15 + 5 + 1), 108-004.03 (registered-nurse course administration), 108-005 (programme approval, 30-day lead time, on-site review, two-year attendance records) and 108-006 (competency evaluations, who may give them, exam construction, the pass standard, the 5-day and 14-day reporting deadlines, three attempts, and testing-contractor quality assurance).\", \"url\": \"https://govdocs.nebraska.gov/epubs/H8310/R172.0108-2022.pdf\"}, {\"label\": \"State of Nebraska document repository — 471 NAC 12, Nursing Facility Regulations, the edition stamped effective 06-26-2021. Establishes § 013.01 (when a certified facility may employ a nurse aide), 013.02 (registry verification, multi-state verification and the duty to report court actions), 013.04(A) (the registry is 'established and maintained by the State' with the State Medicaid agency contracting the State Survey and Certification agency to run it), 013.04(B)(iv) ('No monetary charges related to registration of individuals on the registry are imposed'), 013.04(C) (registry content, including documentation of 24-month ineligibility), 013.04(D) (neglect-finding petitions, the three preconditions, the 150-day decision and the permanence of a repeat finding) and 013.05 (investigation, notice, hearing and reporting of abuse, neglect and misappropriation findings).\", \"url\": \"https://govdocs.nebraska.gov/epubs/H8900/R471.0012-2021.pdf\"}, {\"label\": \"Nebraska DHHS — Medicaid Provider Bulletin No. 07-07 (February 26, 2007), 'Clarification of Facility Obligation to Reimburse Staff for Nurse Aide Training and Competency Evaluation Program (NATCEP) Costs', linked from the Department's Nurse Aide page as 'Nursing homes reimbursement responsibility for nurse aide training'. Establishes the quotation of 42 CFR 483.152(c), the full-cost obligation where the aide was employed or held an offer when training began, the time-based pro rata reimbursement with the worked examples ('six months after completing... 50%'; 'nine months after completing... 25%'), the first-employer rule, and the exclusion of equivalent training such as nurses training.\", \"url\": \"https://dhhs.ne.gov/Medicaid%20Provider%20Bulletins/Provider%20Bulletin%2007-07.pdf\"}, {\"label\": \"Nebraska Rules and Regulations — Title 172 (Professional and Occupational Licensure) chapter index for the Department of Health and Human Services, the page the Department links as its nurse aide regulation. Establishes the current effective date of chapter 108 (9/24/2022) and the existence of the neighbouring, separate chapters 95 (Administration of Medications by Medication Aides and Medication Staff) and 96 (Medication Aide Registry), both 9/24/2022, and 105 (Paid Dining Assistants, 7/13/2021).\", \"url\": \"https://rules.nebraska.gov/rules?agencyId=37&titleId=101\"}, {\"label\": \"Nebraska Rules and Regulations — Title 471 chapter index. Establishes that chapter 12, Nursing Facility Regulations, is currently effective 6/6/2022 — later than the 06-26-2021 edition of that chapter we read.\", \"url\": \"https://rules.nebraska.gov/rules?agencyId=37&titleId=226\"}, {\"label\": \"Nebraska.gov — HHS License Search (the License Information System lookup the Department links as the Nurse Aide Registry). Establishes the three search modes (Individual, Business/Service, Facility/Service), the last-updated stamp in Central Time, the requirement that JavaScript be enabled, and the automated human-verification challenge on the search form.\", \"url\": \"https://www.nebraska.gov/LISSearch/search.cgi\"}]",
   "page_url": "https://licensingatlas.com/cna/ne-cna/"
  },
  {
   "page_id": "nh-cna",
   "state": "New Hampshire",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "New Hampshire Board of Nursing, within the Office of Professional Licensure and Certification (OPLC), Division of Licensing and Board Administration. The Board sets the standards and approves the education programs; the Office issues the license and keeps the registry — 'The office shall maintain a registry of nursing assistants who qualify pursuant to 42 C.F.R. section 483.156' (RSA 326-B:26, as amended effective July 1, 2024).",
   "board_url": "https://www.oplc.nh.gov/new-hampshire-board-nursing",
   "application_url": "https://www.oplc.nh.gov/applications-lna",
   "renewal_cycle": "Every two years, and New Hampshire attaches both a continuing-education requirement and an active-practice requirement to it. The statute: 'All license renewals shall be issued every 2 years in accordance with RSA 310:8', and a licensee who intends to keep practising must report any pending criminal charges, convictions or plea arrangements, have committed no acts that are grounds for discipline, 'Meet continuing competence requirements as defined in rules adopted under RSA 541-A', comply with any discipline order, and meet other board criteria (RSA 326-B:22). The active-practice test, as the Office publishes it for LNAs: 'A minimum of 200 hours of nursing assistant related activities under the supervision of a licensed nurse within the 2 years immediately prior to the date of application — or successful completion of nursing assistant competency testing within 2 years prior to date of application.' That is a genuine alternative, not a formality: an LNA who has not worked 200 hours can re-take the competency test instead. (For comparison on the same Office page: an MNA needs 50 hours, and an RN, LPN or APRN needs 400 hours over four years.) how you file: 'Renewal applications are done online. Visit our online application portal', and continuing education is tracked through CE Broker. The one rule that trips people: 'You can't renew an expired license in the portal. Please use the reinstatement application found below under reinstatement.' RSA 310:8 sets the mechanics of the two-year cycle; that section sits in a different chapter, we had not read its text as of August 16, 2026, and nothing here rests on it beyond the two-year interval RSA 326-B:22 states directly.",
   "ce_hours": "12 contact hours every year — an annual requirement, which is unusual among the states on this site, where most states that require continuing education state it per two-year cycle and many require none at all. The statute is explicit: 'An LNA shall complete 12 hours of continuing education in programs approved by the board each year, provided that licensees who hold a certificate of medication administration shall complete at least 4 hours of those 12 hours in medication administration' (RSA 326-B:31, I). The Board's rule says the same thing in the same units: 'Nur 403.02 Continuing Education Requirements for LNA. Each applicant for renewal, reinstatement, or endorsement of an LNA license shall complete at least 12 contact hours per year of workshops, conferences, lectures, or in-service educational offerings that are designed to enhance nursing assistant knowledge, judgment, and skills. Successful completion of a state nursing assistant examination may be used to fulfill such continuing education requirements.' The Office's own summary states the same obligation across the two-year cycle — '24 contact hours in the two years immediately preceding licensure, conferences, lectures or other education offerings designed to enhance nursing assistant knowledge, judgment, and skills — or successful completion of nursing assistant competency test within 2 years of date of application' — and adds, for MNAs, that '8 of the 24 required contact hours for LNA Licensure must be related to medication administration.' What counts: the Board does not require branded credit. 'The Board does not require that your contact hours be earned at conferences that provide \"official\" contact hours granted by a professional organization. However, the educational offering must: Have specific objectives that guide the learning; Pertain to and enhance the licensee's knowledge, skills and judgment; Pertain to the licensee's scope of practice; Have a method for evaluating the learner's attainment of the objectives; Maintain a list of attendees.' Academic credit converts at 'one credit being the equivalent of 15 contact hours', individualised learning counts hour-for-hour, and 'There is no limit to the number of contact hours that can be completed through independent study.' Documentation: 'The licensee shall maintain documentation of attendance that includes: the title, length and date of the offering and the name of the entity providing the offering.' Two Board interpretations sit on the same page and are not about LNAs — read the heading. The Board published them under the heading 'December 20, 2018 Board of Nursing Interpretation of Nur 403.01', and Nur 403.01 is the continuing-education rule for licensed practical nurses, registered nurses and advanced practice registered nurses. Nur 403.02, quoted above, is the LNA's rule. Both questions are worded for nurses as well: 'Are nurses permitted to repeat the same educational offering in the same two year renewal period and receive credit from the board office for attending both? Yes', and 'Are courses such as glucometer training, use of IV pumps and back training (mandatory training for organizations) counted towards courses that \"are designed to enhance nursing knowledge, judgment, and skills.\"? Yes' — where that closing phrase is Nur 403.01's own wording, while Nur 403.02 says 'nursing assistant knowledge, judgment, and skills'. The Board has published no equivalent interpretation of the LNA rule. They are recorded here because they are the only published Board interpretations on the subject, and an LNA may well hear them applied by analogy — but they are not rulings about the LNA's 12 hours, and this site will not present them as such. Hours are tracked through CE Broker.",
   "exam": "A written test and a clinical test, both required, both taken through a New Hampshire approved tester rather than a national vendor. The statutory requirement is one line — an LNA applicant must 'Pass an examination approved by the board' (RSA 326-B:19, II) — and the Office turns it into a document requirement: the application must include the 'Final Report for the Written and Clinical Competency Testing results'. What is tested and the pass marks, from the Board's proposed readoption of its nursing assistant rules: after completing the programme students are tested on the curriculum skills plus 'Identifying hazardous conditions in the environment', 'Demonstrating emergency measures', 'Manipulating adaptive devices or special equipment', 'Recording stages of the developmental process', 'Recording intake or output', 'Noting abnormalities in behavior or bodily functions', 'Noting and recording results of simple laboratory tests', 'Identifying religious symbols and artifacts', 'Identifying nursing and medical equipment', 'Describing and reporting abuse' and 'Manipulating, and utilizing adaptive devices to promote rest, comfort, and independence'; and 'Students shall achieve a grade of 70, or greater, in examinations testing for theoretical content; and a grade of \"pass\" on skills test.' Those figures come from proposed rather than adopted rule text — see the training details on this page for why New Hampshire's nursing assistant rules chapter is in that position. Reporting: on passing, 'the program shall issue the student a written verification of completion' showing the student's name, the sponsoring institution, the date and 'The number of hours of theoretical instruction and the number of hours of clinical instruction received by the student', and all programmes report passers to the Office within five working days. Accommodations: the Board publishes a 'Request for Nursing Assistant Competency Testing Accommodations Under the Americans with Disabilities Act' requiring a personal statement, documentation from the programme coordinator including any accommodations already granted during the programme, diagnostic testing results by a qualified professional, and an interpretation of the scores with a rationale; an ADA Committee of the Board decides. No limit on attempts is published: RSA 326-B, the Office's LNA pages and checklists, its competency-testing page and the Board's proposed rules were all checked and none states a maximum number of tries, so none is asserted here. Retesting has a second use in New Hampshire — passing the competency test satisfies the 'active in practice' condition for license renewal, and the continuing-education rule provides that 'Successful completion of a state nursing assistant examination may be used to fulfill such continuing education requirements.'",
   "fees": "$66 to the Office, and it is the same $66 three times over: the Board of Nursing fee schedule lists Licensed Nursing Assistant Application Fee $66.00, Renewal Fee $66.00 and Reinstatement Fee $66.00. A footnote on the schedule explains part of it: the asterisk on all three LNA lines 'Denotes inclusion of mandatory Professional Health Program (PHP) fee of $28.00 to be paid at the time of licensing' — so a substantial share of the LNA fee is a health-programme assessment rather than a licensing charge, and the same $28 rides on the RN and LPN fees of $116. Fees are not refundable, and the Office warns against paying twice: 'To avoid a delay in licensure, please do not submit multiple applications.' Related fees on the same schedule: Medication Nursing Assistant application, renewal and reinstatement $11.00 each; Temporary Licensed Practical Nurse and Temporary Registered Nurse applications $20.00; Registered Nurse and Licensed Practical Nurse $116.00; APRN $110.00; and education Program Approvals $250.00 for application, renewal and reinstatement. Paper applications take only three payment forms: 'Personal Check, Money Order or Cashier's Check', mailed with the application to the Office at 7 Eagle Square, Concord, NH 03301. Not paid to the office: the criminal history record check, which the statute assigns to the applicant — 'The applicant shall bear the cost of a criminal history record check' (RSA 326-B:15, IV) — and the cost of the education programme and of the written and clinical competency testing, neither of which the state sets or publishes. No examination fee appears anywhere on the Board of Nursing fee schedule.",
   "legal_basis": "[{\"citation\": \"N.H. Rev. Stat. Ann. ch. 326-B (Nurse Practice Act)\", \"what_it_governs\": \"The entire New Hampshire nursing scheme including the LNA: the definition of 'licensed nursing assistant' (326-B:2, IV) and 'medication nursing assistant' (326-B:2, VI); the Board's powers and rulemaking (326-B:3, :4, :9); the LNA scope of practice, the medication-administration condition and the reservation of scope expansion to the legislature (326-B:14); criminal history record checks and who bears their cost (326-B:15); the licensure requirements for all LNA applicants (326-B:16, II); licensure by examination (326-B:19) and by alternate experience for military medics and NREMT-certified EMTs (326-B:21-a); two-year renewal (326-B:22); temporary licenses and their 180-day ceiling (326-B:24); the nursing assistant registry (326-B:26); the certificate of medication administration (326-B:27); delegation (326-B:28); the 12-hours-a-year continuing education requirement (326-B:31); education programme standards and approvals (326-B:32); discipline (326-B:37); unlawful acts including practising on a lapsed license and using the LNA designation without one (326-B:41); and the exemptions (326-B:43).\", \"url\": \"https://gc.nh.gov/rsa/html/XXX/326-B/326-B-mrg.htm\"}, {\"citation\": \"N.H. Rev. Stat. Ann. 326-B:19 (Licensed Nursing Assistant; Licensure by Examination), as amended by Laws 2025, ch. 13:1, effective May 8, 2025\", \"what_it_governs\": \"The three initial-license requirements: documentation of successful completion and certification from a board-approved nursing assistant education programme OR documentation of successful completion of a fundamentals of nursing curriculum or its equivalent from a board-approved nursing education programme; passing an examination approved by the board; and meeting other board criteria. The 2025 amendment is the current text.\", \"url\": \"https://gc.nh.gov/rsa/html/XXX/326-B/326-B-mrg.htm\"}, {\"citation\": \"N.H. Rev. Stat. Ann. 326-B:26 (Nursing Assistant Registry), as amended by Laws 2024, ch. 327:108, effective July 1, 2024\", \"what_it_governs\": \"The federal registry underneath the license: 'The office shall maintain a registry of nursing assistants who qualify pursuant to 42 C.F.R. section 483.156', with registered nursing assistants required to comply with OBRA 1987, sections 1819 and 1919 of the Social Security Act, and the Nurse Practice Act. The 2024 amendment moved the duty from the board to the office.\", \"url\": \"https://gc.nh.gov/rsa/html/XXX/326-B/326-B-mrg.htm\"}, {\"citation\": \"N.H. Code Admin. R. Nur 400 (continuing education), in particular Nur 403.02 and Nur 403.04\", \"what_it_governs\": \"The LNA continuing-education obligation of at least 12 contact hours per year for renewal, reinstatement or endorsement, the rule that passing a state nursing assistant examination may substitute for it, the parallel 4-hours-per-year medication requirement for MNAs at Nur 403.03, and the conversion of academic credit at 15 contact hours per credit. ⚠ Nur 400 is itself under active rulemaking — the Office lists 'Nur 400 - Continued Status' under Proposed Rules with the public comment period closed April 30, 2026.\", \"url\": \"https://www.oplc.nh.gov/board-nurses-education-and-training\"}, {\"citation\": \"N.H. Code Admin. R. Chapter Nur 700 (Nursing Assistants) — expired April 14, 2024, readoption proposed November 20, 2025\", \"what_it_governs\": \"The nursing assistant education programme and competency evaluation standards: programme approval, the 100 clock hours split 40 theory and 60 concurrent clinical, the 16 pre-contact hours, the full curriculum, the 8:1 clinical student-to-instructor ratio, instructor qualifications, the competency evaluation subject matter and the 70-percent theory and pass/fail skills standards, written verification of completion, and registry reporting. ⚠ The status is the point: the Board's own readoption document records that this chapter was 'previously effective 4-14-14 (Document #10570) and expired 4-14-24', and the Office's Laws and Rules page still lists Nur 700 under Proposed Rules with the public comment period closed March 5, 2026. Everything this page attributes to Nur 700 is attributed to that expired-and-proposed text on its face, never as currently effective rule.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/2026-9-ip-rule-nur-700.pdf\"}, {\"citation\": \"42 CFR Part 483, Subpart D — in particular 42 CFR 483.156\", \"what_it_governs\": \"The federal registry requirement New Hampshire's RSA 326-B:26 points at by name, and the OBRA 1987 frame the same section incorporates. The registry-reporting duty in the Board's nursing assistant rules likewise cites 'OBRA 1987' as its source of authority alongside RSA 326-B.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.156\"}]",
   "exam_vendor": "There is no national testing vendor in New Hampshire, and no single state vendor either — the Office publishes a two-part list of approved testers. Under the heading 'Competency Testing Services and Agencies', its 'Competency Testing Services' entry is Lakes Region Community College in Laconia and its 'Competency Testing Agencies' entry is Excel Testing in Manchester. The Board's ADA accommodation form confirms the arrangement from the other direction: after the Board's ADA Committee decides a request, 'the decision will be submitted to the Nursing Assistant Competency Testing Company' — a company, named only generically by the Board. The statute keeps the approval power and delegates nothing else: an LNA applicant must 'Pass an examination approved by the board' (RSA 326-B:19, II), and the Board's proposed readoption of its rules puts the competency evaluation inside the approved education programme itself — students are tested after completing the curriculum, must 'achieve a grade of 70, or greater, in examinations testing for theoretical content; and a grade of \"pass\" on skills test', and the programme then issues written verification and reports passers to the Office 'within 5 working days.' What the applicant hands in is a document from whoever tested them: the Office's checklist asks for the 'Final Report for the Written and Clinical Competency Testing results' alongside the 'LNA Education Program Certificate'. No national vendor name appears anywhere in the Office's LNA pages, its three LNA checklists, its competency-testing page, the Nurse Practice Act or the Board's proposed nursing assistant rules — all were checked and none names Credentia, Prometric, Pearson VUE or the NNAAP.",
   "training_hours": "100 clock hours — 40 hours of theory and 60 hours of concurrent clinical experience — but a reader deserves to know exactly where that number currently lives, because New Hampshire's nursing assistant rules chapter has expired. The figure appears in the Board's own rule text: 'Programs designed to provide pre-licensure instruction to candidates seeking licensure as a nursing assistants shall: (a) Consist of no less than 100 clock hours of instruction consisting of 40 hours of theory and 60 hours of concurrent clinical experience; (b) Include at least a total of 16 hours of training in the following areas prior to any direct contact with a patient: (1) Communication and interpersonal skills; (2) Infection control; (3) Safety and emergency procedures, including the Heimlich maneuver; (4) Promoting residents' independence; and (5) Respecting residents' rights.' The status of that text: it is Nur 702.01 as the Board proposed it on November 20, 2025, in a rulemaking whose own opening line records that Chapter Nur 700 was 'previously effective 4-14-14 (Document #10570) and expired 4-14-24.' The Office's Laws and Rules page still lists 'Nur 700 - Nursing Assistants' under Proposed Rules with the note 'Public comment period closed March 5, 2026', and the rules index at the General Court still shows the pre-2024 chapter structure while the chapter's own page no longer serves. So as of 2026-08-16 the 100/40/60 split is the Board's published standard, appearing in the chapter that expired in April 2024 and in the readoption the Board has proposed but not yet adopted. The Office corroborates the total on its own site in a report it publishes there: 'To become an LNA in New Hampshire, a typical applicant must: 1) Complete a board approved educational program of 100 hours 2) Pass a written and clinical test, and 3) Submit an FBI background check' — that report is a consultant's review prepared under a U.S. Department of Labor grant using 2019-2020 data, so it corroborates the figure without being the Board's rule. What the statute itself sets: no hours at all. RSA 326-B:19 requires only 'successful completion and certification from a board-approved nursing assistant education program', and RSA 326-B:32 leaves the standards to the Board — which is why the expiry of the rule matters. Other content requirements in the same proposed text: basic nursing skills, personal care skills, mental health and social service needs, care of cognitively impaired residents, basic restorative services and residents' rights, plus a hard staffing rule — 'Maintain a student-to-instructor ratio that shall not exceed 8:1 in the clinical setting.' Instructors: 'The instruction of nurse aides shall be performed by or under the general supervision of a registered nurse who possesses a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of long-term care facility services', and instructors must have completed a course in teaching adults or have equivalent experience.",
   "lapse_rule": "New Hampshire splits it at the one-year mark, and the split changes which application you file. Expired less than one year — reinstatement on paper: 'If your license has been expired less than 1 year, please complete the paper Universal Application for License Renewal AND the [LNA Reinstatement Application] and mail it to OPLC with your reinstatement fee.' The reinstatement fee is $66, the same as a renewal, and paper applications take only a personal check, money order or cashier's check. Expired or lapsed more than one year — start again: 'If your license has been expired or lapsed for more than 1 year, please reapply online using our online application portal.' The Office also warns that the renewal portal will not accept an expired license at all — 'You can't renew an expired license in the portal.' What reinstatement requires substantively is the same pair of tests as renewal, because the continuing-education rule names reinstatement expressly: 'Each applicant for renewal, reinstatement, or endorsement of an LNA license shall complete at least 12 contact hours per year' (Nur 403.02), and the active-practice condition is either 200 hours of supervised nursing assistant activity in the previous two years or 'successful completion of nursing assistant competency testing within 2 years prior to date of application' — which is the route back for someone who has been out of work. Practising on a lapsed license is an unlawful act, not merely an administrative problem: it is unlawful to 'Practice as a licensee without a license or when the license to do so has been revoked or suspended or when the license to do so has lapsed' (RSA 326-B:41, II). No grace period is published by the Office for LNAs, and none appears in RSA 326-B:22; both were checked.",
   "reciprocity": "New Hampshire calls it endorsement, and it is open only to people whose out-of-state credential is currently active. The Office's checklist is explicit at the top: 'Please use this checklist to submit your application only if you hold an active license in another state. If you do not have an active license in another state, please see the other options to Apply for a New License.' Three items are required: the application fee, a criminal background check, and 'Verification of out-of-state nursing assistant license(s): Upload into the online application' — the applicant uploads the verification rather than the Office chasing the other state. Continuing education follows you across the line: the rule requiring 12 contact hours per year applies to 'Each applicant for renewal, reinstatement, or endorsement of an LNA license' (Nur 403.02). A temporary license is signposted on the same checklist as a parallel track — 'Please see information on Temporary Licensure here before applying for a Temporary License' — with instructions to create a portal account and 'Choose your profession as Temporary/Emergency license, your license type as Temporary, and obtained by as Application.' A structural point worth knowing: the two Nurse Practice Act sections at RSA 326-B:20 and RSA 326-B:21 were repealed by Laws 2024, ch. 327:112, effective July 1, 2024, so endorsement is no longer described in its own statute; an endorsement applicant is an LNA applicant under the general requirements of RSA 326-B:16, II, processed under the Office's published procedure. Two routes that look like reciprocity but are not: the alternate-experience pathway for military medics and NREMT-certified EMTs (RSA 326-B:21-a), which deems the applicant to have taken a board-approved course rather than recognising another state's license; and the nursing-student pathway in RSA 326-B:19, I, which accepts 'successful completion of fundamentals of nursing curriculum, or its equivalent, from a board-approved nursing education program.' No endorsement fee separate from the $66 application fee is published, and no processing time is published for any LNA route; both were checked across the Office's LNA pages, its three checklists and its fee schedule.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"New Hampshire OPLC — Applications for LNA. Establishes the three application routes and their checklists, 'Initial applications are done online', the reinstatement split at one year ('If your license has been expired less than 1 year... If your license has been expired or lapsed for more than 1 year, please reapply online'), the paper-payment forms accepted ('Personal Check, Money Order or Cashier's Check'), the mailing address at 7 Eagle Square, the warning that 'You can't renew an expired license in the portal', and the links to the education-requirements, fee, license-period, license-lookup, background-check, temporary-license, reciprocity, letter-of-verification and wall-certificate resources.\", \"url\": \"https://www.oplc.nh.gov/applications-lna\"}, {\"label\": \"New Hampshire OPLC — Checklist: LNA License by Competency Examination Application. Establishes the five required items: Application; application fee, non-refundable, with 'please do not submit multiple applications'; 'LNA Education Program Certificate'; 'Final Report for the Written and Clinical Competency Testing results'; and 'Criminal Background Check'.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/lna-exam-checklist_0.pdf\"}, {\"label\": \"New Hampshire OPLC — Checklist: LNA License by Alternate Experience Application. Establishes the three required items for the military and NREMT route: the application fee, proof of the enlisted occupational code under RSA 326-B:21-a or current NREMT certification as an EMT-basic, EMT-advanced or paramedic in any United States jurisdiction, and a criminal background check.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/nur-checklist-lna-alternate-experience-20240524_v2.pdf\"}, {\"label\": \"New Hampshire OPLC — Checklist: LNA License by Endorsement (Reciprocity). Establishes the active-license gate ('submit your application only if you hold an active license in another state'), the three required items (fee, criminal background check, and uploaded verification of out-of-state nursing assistant licenses), and the parallel temporary-license application procedure.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/nur-checklist-lna-endorsement_v2.pdf\"}, {\"label\": \"New Hampshire OPLC — Board of Nurses Education and Training. Establishes the LNA active-in-practice requirement ('A minimum of 200 hours of nursing assistant related activities under the supervision of a licensed nurse within the 2 years immediately prior to the date of application — or successful completion of nursing assistant competency testing within 2 years prior to date of application'), the MNA 50-hour and RN/LPN 400-hour comparisons, the LNA continuing-education summary of 24 contact hours over two years and the MNA's 8 medication hours, the reproduced text of Nur 403.01 through Nur 403.04, the Board's position that contact hours need not be 'official', the five conditions an educational offering must meet, the documentation duty, and the December 20, 2018 Board interpretations on repeating offerings and on employer-mandated training — which the page heads 'Board of Nursing Interpretation of Nur 403.01', the nurses' continuing-education rule, not the LNA rule Nur 403.02.\", \"url\": \"https://www.oplc.nh.gov/board-nurses-education-and-training\"}, {\"label\": \"New Hampshire OPLC — Board of Nursing License Fees. Establishes Licensed Nursing Assistant application, renewal and reinstatement fees of $66.00 each, the asterisk footnote that this 'Denotes inclusion of mandatory Professional Health Program (PHP) fee of $28.00 to be paid at the time of licensing', the Medication Nursing Assistant fees of $11.00, the Temporary LPN and Temporary RN application fees of $20.00, the RN and LPN fees of $116.00, the APRN fees of $110.00, and the Program Approvals fees of $250.00.\", \"url\": \"https://www.oplc.nh.gov/board-nursing-license-fees\"}, {\"label\": \"New Hampshire OPLC — Board of Nursing Laws and Rules. Establishes the current rulemaking state: 'Recently Adopted Rules — Nur 608 - Nurse Externs - Effective August 24, 2026'; 'Proposed Rules — Nur 400 - Continued Status - Public comment period closed April 30, 2026'; 'Nur 601 – Nur 607 - Nursing Education Program Approval - Public comment period closed March 5, 2026'; 'Nur 700 - Nursing Assistants - Public comment period closed March 5, 2026'; and 'Nur 900 - Certified Assisted Living Medication Aide (CALMA) Education, Examination, and Certification - Advance Public comment period closed March 5, 2026'. Also links RSA 326-B and 'CHAPTER Nur 100-800'.\", \"url\": \"https://www.oplc.nh.gov/board-nursing-laws-and-rules\"}, {\"label\": \"New Hampshire Board of Nursing — Initial Proposal, Chapter Nur 700 Licensed Nursing Assistants (dated 11-20-25). Establishes the readoption's own status line — 'Adopt Nur 700, previously effective 4-14-14 (Document #10570) and expired 4-14-24' — and the substantive standards: 'Consist of no less than 100 clock hours of instruction consisting of 40 hours of theory and 60 hours of concurrent clinical experience'; the 16 pre-contact hours and their five subjects; the full curriculum across basic nursing, personal care, mental health and social service needs, cognitively impaired residents, basic restorative services and residents' rights; the 8:1 clinical ratio; the competency evaluation subject list and 'Students shall achieve a grade of 70, or greater, in examinations testing for theoretical content; and a grade of \\\"pass\\\" on skills test'; the written verification of completion and the five-working-day reporting duty; the instructor qualifications (an RN with 2 years' nursing experience, at least 1 in long-term care, plus adult-teaching experience); the continuing-education competency domains; and Nur 704.01 Registry Reporting.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/2026-9-ip-rule-nur-700.pdf\"}, {\"label\": \"New Hampshire OPLC — Competency Testing Services and Agencies. Establishes that New Hampshire's nursing assistant competency testing runs through state-listed providers rather than a national vendor: 'Competency Testing Services — Lakes Region Community College, 379 Belmont Road, Laconia, NH 03246' and 'Competency Testing Agencies — Excel Testing, 70 Market Street, Manchester, NH 03101'.\", \"url\": \"https://www.oplc.nh.gov/competency-testing-services-and-agencies\"}, {\"label\": \"New Hampshire Board of Nursing — Request for Nursing Assistant Competency Testing Accommodations Under the Americans with Disabilities Act. Establishes the four documents an accommodation request needs, that 'the ADA Committee of the Board will review the information submitted and make a determination', and that 'the decision will be submitted to the Nursing Assistant Competency Testing Company'.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/lna-competency-testing_v2.pdf\"}, {\"label\": \"New Hampshire OPLC — Nursing Assistant Educational Programs. The Office's published list of approved LNA programmes with addresses, phone numbers and named RN programme coordinators, covering community colleges (Lakes Region, River Valley, White Mountains, Manchester Community College Workforce Development Center), hospitals (Cheshire Medical Center, Cottage Hospital, BILH Exeter, Portsmouth Regional, St. Joseph's), county and state facilities (Coos County Nursing Hospital, Merrimack County Nursing Home, Sullivan County Health Care, Glencliff Home, New Hampshire Veterans Home) and private providers (LNA Health Careers, Thrive Health Career Institute, Team Select Home Care).\", \"url\": \"https://www.oplc.nh.gov/nursing-assistant-educational-programs\"}, {\"label\": \"New Hampshire General Court — RSA Chapter 326-B, Nurse Practice Act (merged chapter text). Establishes the LNA definition (326-B:2, IV), the LNA scope of practice and medication conditions (326-B:14), criminal history record checks including the two-attempt fingerprint fallback and the July 1, 2026 amendment (326-B:15), the LNA-specific licensure requirements (326-B:16, II), licensure by examination as amended in 2025 (326-B:19), the repeal of 326-B:20 and 326-B:21 effective July 1, 2024, licensure by alternate experience (326-B:21-a), two-year renewal (326-B:22), temporary licenses (326-B:24), the nursing assistant registry (326-B:26), the certificate of medication administration (326-B:27), the 12-hours-a-year continuing education requirement (326-B:31), education programme approval (326-B:32), unlawful acts (326-B:41) and exemptions (326-B:43).\", \"url\": \"https://gc.nh.gov/rsa/html/XXX/326-B/326-B-mrg.htm\"}, {\"label\": \"New Hampshire General Court — Administrative Rules, Board of Nursing table of contents (Nur 100-800). Establishes that the rules index still lists 'CHAPTER Nur 700 NURSING ASSISTANTS' with its pre-2024 structure — part Nur 701 nursing assistant registry, part Nur 702 competency evaluation, part Nur 703 records, part Nur 704 educational programs for nursing assistants — while the chapter's own page no longer serves content.\", \"url\": \"https://gc.nh.gov/rules/state_agencies/nur.html\"}, {\"label\": \"New Hampshire OPLC — Occupational Licensing Review Project final report on Licensed Nursing Assistants and Medication Nursing Assistants, prepared for the Office under a U.S. Department of Labor Employment and Training Administration grant. Corroborates the 100-hour figure — 'To become an LNA in New Hampshire, a typical applicant must: 1) Complete a board approved educational program of 100 hours 2) Pass a written and clinical test, and 3) Submit an FBI background check' — and describes the alternative pathways and the federal registry duty under 42 CFR 483.156. Recorded with its vintage: it is a consultant's review using 2019-2020 labour-market data and citing rules by their pre-2024 numbering, published on the Office's own site; it is not the Board's rule.\", \"url\": \"https://www.oplc.nh.gov/sites/g/files/ehbemt441/files/inline-documents/sonh/clear-nursing.pdf\"}, {\"label\": \"New Hampshire OPLC — License Lookup (public license verification). The Office's public verification tool for all professions it licenses, linked from the LNA application page.\", \"url\": \"https://forms.nh.gov/licenseverification/\"}]",
   "page_url": "https://licensingatlas.com/cna/nh-cna/"
  },
  {
   "page_id": "nj-cna",
   "state": "New Jersey",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "New Jersey Department of Health — Certification Program, within the Division of Certificate of Need and Licensing (the Department's older documents call it the Division of Health Facilities Evaluation and Licensing). The Department certifies; a contractor keeps the registry: 'PSI is a State-approved independent testing company under contract to the Department to provide support in the development, administration, scoring, and reporting of results of the Nurse Aide in Long Term Care Facilities Competency Evaluation. In addition, PSI maintains the New Jersey Nurse Aide Registry and the New Jersey Nurse Aide Abuse Registry.' No board of nursing is involved in the nurse aide credential — the New Jersey Board of Nursing appears only where its Unlicensed Assistive Personnel curriculum is used, in hospitals and in the homemaker-home health aide pathway.",
   "board_url": "https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/",
   "application_url": "https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/apply/index.shtml",
   "renewal_cycle": "Every two years, and the Department states four conditions rather than one. 'Renewal and update of your listing on the Registry is required every two years. To be recertified, you must have: A current, valid nurse aide or personal care assistant certificate; At least seven hours of paid employment performing nursing or nursing-related services, in a licensed health care facility or agency, within the 24 months preceding your certificate expiration date; No revocation or suspension of a certificate; A criminal background check, with fingerprinting, prior to the certification expiration date.' Two things make New Jersey's renewal distinctive. First, the work test is seven hours over two years — among the lowest published for any state on this site, and the qualifying setting is broad: 'a licensed health care facility or agency', not only a nursing home. Second, the background check recurs: most states run fingerprints once, at entry; New Jersey requires a fresh fingerprint-supported check before every expiration date. Address changes are a two-call job and the Department is emphatic about it: 'Nurse aides and/or personal care assistants who have moved since the last renewal must notify the New Jersey Nurse Aide Registry immediately at 877-774-4243. In addition, nurse aides and personal care assistants must notify the Criminal Investigations Unit (CIU) of their new address at 609-292-4303.' No continuing education is among the four conditions — see the continuing-education details on this page. No renewal fee is published by the Department, and no renewal notice or reminder is described on any Department page we checked.",
   "ce_hours": "None is published as a condition of New Jersey nurse aide recertification. The Department's recertification page lists exactly four requirements — a current valid certificate, at least seven hours of paid nursing or nursing-related employment in the previous 24 months, no revocation or suspension, and a fingerprint-supported criminal background check before the expiration date — and continuing education is not among them. Sources checked, finding none: the Department's Nurse Aides/Personal Care Assistants page, its Apply for a Certification page, its Renew or Replace a Certificate page, its Submit Payments page and its NATCEP guide. Continuing education does appear in New Jersey's nurse aide scheme, but on the way IN rather than on the way round: an out-of-state aide using reciprocity Route 1 must show that 'Within the prior 24 months, you must have completed 24 hours of approved CEUs. These CEUs must include 12 hours of approved continuing education in care for residents with Alzheimer's Disease and other dementia-related disorders, and a total of 12 hours of approved continuing education in the following areas: infection control procedures; emergency procedures; abuse and neglect, and misappropriation of resident property; resident rights; and pharmacy.' That is a condition of transferring in, not of staying certified in New Jersey — a distinction it is easy to collapse, and this page does not collapse it. A separate continuing-education duty does attach to the medication aide certificate that sits on top of the CNA: 10 hours every two years under N.J.A.C. 8:36-9.2(d), obtained through the employer, with 'Section 2 of your renewal form... filled out by your employer to attest to your 10 hours of continuing education.'",
   "exam": "Two parts: a practical (clinical) skills evaluation and a written or oral competency examination. The Department names both as separate components of certification — 'training, practical skills evaluation, a written/oral exam and a criminal background check' — and its reciprocity Route 2 requires an out-of-state aide to 'pass the New Jersey clinical skills competency examination and the written/oral competency examination', which confirms the oral form is an alternative to the written one rather than an addition. The examination is developed, administered, scored and reported by PSI under contract to the Department, and the Department's guide treats examination security as PSI's: the approval stamp and school code issued to every approved programme 'are issued for the security of the examination.' The candidate's own guide is the nurse aide examination candidate information bulletin, which the Department links from its application page and also offers to send directly — a candidate may contact 'The Certification Program, to receive New Jersey's Nurse Aide Examination Candidate Information Bulletin or a list of approved programs.' Programmes receive candidate handbooks from PSI at no charge, and the Department asks them to 'encourage nurse aide candidates to retain the candidate Information Bulletin for future reference.' The bulletin could not be read as of August 16, 2026: the address the Department links now lands on the testing company's general test-taker home page rather than on the bulletin. Everything that bulletin alone would settle is therefore absent from this page rather than guessed — no question count, no time limit, no number of skills, no passing score, no limit on attempts and no examination fee is stated here, and none of those appears anywhere on the Department's own nurse aide pages, in its NATCEP guide or in its published payment schedule.",
   "fees": "New Jersey publishes its programme fees clearly and its candidate fees not at all. On the Department's payment page, under 'Certified Nurse Aide and Certified Medication Aide Programs', the published charges are: 'Certified Nurse Aide Program Approval Fee ($75)'; 'Curriculum Fee ($75)'; 'Instructor and Evaluator Fee ($75)'; 'CNA Instructor and Evaluator List ($75)'; and 'Certified Medication Aide Program Approval Fee ($100)'. Those are paid by schools, facilities and instructors, not by aides. A divergence worth knowing, recorded both ways: the Department's NATCEP guide — whose regulatory references it dates to October 31, 2006 — states a $75 course-approval check but prices two of the other items lower, at '$50.00 (per Copy)' for additional copies of the Curriculum and 'a check for $50 made payable to the New Jersey Department of Health for each instructor or evaluator' registering for a workshop. The live payment page says $75 for both. This page reports both figures with their sources and does not pick one. What the individual candidate pays is not published by the Department: no application fee, certification fee, recertification fee, examination fee or re-test fee appears on the Department's nurse aide pages, on its 'Submit Payments' page or in its NATCEP guide, all of which were checked. The examination fee is set out in the candidate bulletin published by the Department's testing contractor, and that bulletin could not be read as of August 16, 2026. What you should not be paying at all: if you were employed by, or held an offer from, a long-term care facility when your training began, the facility owes the whole cost including textbooks; if you are hired within twelve months of completing, it owes a prorated reimbursement; and no aide 'shall be required, as a condition of employment, to pay the cost of the training program in the event of voluntary or involuntary termination of employment.'",
   "legal_basis": "[{\"citation\": \"N.J.A.C. 8:39-43 (Certification of Nurse Aides in Long-Term Care Facilities), within N.J.A.C. 8:39, Standards for Licensure of Long-Term Care Facilities\", \"what_it_governs\": \"The whole New Jersey nurse aide certificate: the requirements for certification, the 90-hour training programme with its 50 classroom and 40 clinical hours, programme approval and its withdrawal, instructor and evaluator qualifications (8:39-43.10), student and statistical records (8:39-43.11 and 43.12), termination of a programme (8:39-43.13), and the fee-protection rules barring charges to employed aides, requiring pro rata reimbursement within twelve months of completion, and forbidding repayment as a condition of employment (8:39-43.18(d), (e) and (g)). The Department cites its authority for chapter 8:39 as 'N.J.S.A. 26:2H-1 et seq., specifically 26:2H-5', and readopted the chapter with technical changes, setting a new expiration date of 2028.\", \"url\": \"https://www.nj.gov/health/legal/rules/\"}, {\"citation\": \"N.J.A.C. 8:39-43.10 (nurse aide training program instructor/evaluator), adopted amendment effective November 6, 2023 (R.2023 d.123, 55 N.J.R. 11(1))\", \"what_it_governs\": \"The rewritten evaluator standard. The adopted text requires an evaluator to 'Be licensed in New Jersey as a registered professional nurse; and... Possess at least one year of full-time or full-time equivalent experience as a registered professional nurse providing care for the elderly or the chronically ill of any age', deleting the former three-year facility-experience, one-year-in-long-term-care and Department-workshop requirements. Proposed December 5, 2022 at 54 N.J.R. 2197(a); adopted September 21, 2023 without change; expiration date November 22, 2028. The Department's stated rationale was that the amendment 'would not impose standards on long-term care facilities (LTCFs) in New Jersey that exceed those contained in applicable Federal standards, which may be found at 42 CFR 483.152(a)(5).'\", \"url\": \"https://www.nj.gov/health/legal/documents/adoption/NOR%208_39-43.10.pdf\"}, {\"citation\": \"N.J.A.C. 8:39-19.5 (Mandatory staff qualifications; health history and examinations)\", \"what_it_governs\": \"The two-step Mantoux tuberculin skin test for new employees of a long-term care facility, its four exceptions, the chest x-ray and chemoprophylaxis follow-up on a significant result, and the exclusion from work of anyone with suspected or diagnosed active tuberculosis until cleared in writing. The Department's Certification Program has interpreted the section to reach nurse aide students who provide direct care, and requires the testing before the first day of classroom instruction.\", \"url\": \"https://www.nj.gov/health/legal/rules/\"}, {\"citation\": \"N.J.A.C. 8:43I (Criminal Background Investigations: Nurse Aides, Personal Care Assistants and Assisted Living Administrators)\", \"what_it_governs\": \"The fingerprint-supported criminal background investigation that is one of the four components of New Jersey nurse aide certification and that must be repeated before each certificate expiration date. Listed by the Department among the State Long Term Care rules it administers.\", \"url\": \"https://www.nj.gov/health/healthfacilities/rules.shtml\"}, {\"citation\": \"N.J.A.C. 8:43G-18.3(e) and (f) (Hospital Licensing Standards)\", \"what_it_governs\": \"The hospital side of the boundary. New Jersey does not require nurse aide certification in acute care, but hospitals 'must use the approved New Jersey State Board of Nursing Unlicensed Assistive Personnel (UAP) curriculum to develop and implement a training program for unlicensed assistive personnel', and certified nurse aides must staff a hospital's licensed long-term care or sub-acute units. Cited by the Department on its own Apply for a Certification page.\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/apply/index.shtml\"}, {\"citation\": \"42 CFR Part 483, Subpart D — in particular 42 CFR 483.151 and 483.152\", \"what_it_governs\": \"The federal frame New Jersey's programme implements. The Department's guide cites 42 CFR 483.151(b)(2) for the mandatory two-year withdrawal of NATCEP approval from a long-term care facility with substandard quality of care or a civil monetary penalty of at least $5,000, and 42 CFR 483.152 for the rule that in a facility-based programme the training 'may be performed under the general supervision of the Director of Nursing (DON) for the facility who generally may not perform the actual training.' The 2023 evaluator amendment was justified against 42 CFR 483.152(a)(5), and the Department cites 42 CFR 431, 433 and 483 as the basis for its on-site monitoring of training courses.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"N.J.A.C. 8:36-9.2(d) (Standards for Licensure of Assisted Living Residences, Comprehensive Personal Care Homes, and Assisted Living Programs) — medication aide renewal\", \"what_it_governs\": \"The neighbouring credential's renewal rule, quoted by the Department on its own Certified Medication Aide page: 'At least once every two years, on a schedule to be determined by the Department, a medication aide shall file an application for renewal of current certification. In order to be eligible to renew a current certification, the medication aide shall have completed at least 10 hours of continuing education, seminars, or in-service training every two-year certification period.' Recorded to keep the medication aide's continuing-education duty from being mistaken for a nurse aide one.\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/certified-medication-aide/\"}]",
   "exam_vendor": "PSI Services, under contract to the New Jersey Department of Health, and its role goes well beyond running the test. The Department's own guide states it: 'After approval of the NATCEP, the Department will notify PSI. PSI is a State-approved independent testing company under contract to the Department to provide support in the development, administration, scoring, and reporting of results of the Nurse Aide in Long Term Care Facilities Competency Evaluation. In addition, PSI maintains the New Jersey Nurse Aide Registry and the New Jersey Nurse Aide Abuse Registry.' What PSI gives a newly approved programme: 'an approval stamp, a school code, an initial supply of application forms, and nurse aide candidate handbooks... The approval stamp and the school code are issued for the security of the examination. Please allow thirty (30) days to receive the NATCEP materials. There is no charge for any items ordered.' PSI also 'provides all approved NATCEPs with monthly data reports', with a copy to the Certification Program, and changes to those reports must be routed through the Department rather than requested from PSI directly. The Department acts as the escalation path when the vendor relationship goes wrong — it publishes an explicit procedure for 'Nurse Aide Problems with PSI', asking for the aide's name, Social Security number, address and phone, certification number, the nature of the problem, 'The name of the PSI representative with whom you spoke and the information that was provided by the representative', and 'The PSI assessment center location and time of day that the incident occurred.' Contact and address: the Department publishes 'New Jersey Nurse Aide Registry, PSI, 3525 Quakerbridge Road, Suite 1000, Hamilton Township, New Jersey 08619, Toll-free telephone number: 877-774-4243' as the address for replacing a lost certificate or changing a reporting name, address or employer.",
   "training_hours": "90 hours — 50 classroom and 40 clinical — and New Jersey states the split on its own live page rather than leaving it to a handbook: 'Certification candidates must successfully complete the Nurse Aide in Long Term Care Facilities Training and Competency Evaluation Program (NATCEP). The training course is 90 hours, consisting of 50 classroom hours and 40 clinical hours.' The Department's NATCEP guide states the same total as 'a ninety-hour state-approved nurse aide in long-term care facilities training course', and the requirement lives in the certification subchapter of the long-term care licensing rules, N.J.A.C. 8:39-43. The clinical hours have a setting requirement, not just a count — the clinical portion is done in a New Jersey licensed long-term care facility, which is why every approved programme outside a facility must file 'a contract with the host facility (clinical site)' with its course application. The curriculum is the state's and it is closed: 'The New Jersey Curriculum for Nurse Aide Personnel in Long Term Care Facilities \"Curriculum\" has been developed by the Department for use in the NATCEP. The training programs must use the Department approved Curriculum. The entire content of the Curriculum is to be covered during each training course. Content may neither be added to nor deleted from the curriculum. While the modules shall be presented in sequence, the lessons within each module may be reordered to maximize the teaching process.' The four modules are 'The Core Curriculum for the Nurse Aide in Long-Term Care Facilities Training and Competency Evaluation Program', 'Psycho-Social Needs of Residents', 'Physical Needs of the Resident', and 'Spiritual, Recreational, and Activity Needs of the Resident'. Each module carries 'required student objectives, content map, and suggested learning experiences', and lesson plans must show 'Required Objectives, Content Map, Method of Presentation, Clinical Activities, and Method of Evaluation for each objective.' The instructor picks the textbook and writes the tests and quizzes, and 'is responsible for developing criteria for evaluating return demonstrations and clinical performance of the students.' No unit-by-unit hour schedule is published on the Department's site; the closed curriculum, not an hours table, is the control.",
   "lapse_rule": "What New Jersey publishes about a lapsed nurse aide certificate is thin, and this page says so rather than filling the gap. The Department's recertification page states the four conditions for being recertified and the two-year cycle, but it does not state what happens if the certificate expires, whether there is a grace period, whether a lapsed aide may re-test, or how long a lapse can run before retraining is required. Sources checked: the Nurse Aides/Personal Care Assistants page, the Apply for a Certification page, the Renew or Replace a Certificate page and the Department's NATCEP guide. The Department's candidate bulletin, published by its testing contractor, is the document most likely to carry the answer, and it could not be read as of August 16, 2026. What is published, and is not the same thing: a Certified medication Aide whose certificate lapses has a stated route — email the Department with the name, certification number, an explanation and a phone number — with the warning that 'If you are not actively employed as a C.M.A., we cannot grant an extension for a lapsed certificate.' That is the medication aide credential, not the nurse aide certificate, and it is recorded here only so a reader does not mistake one for the other. Separately from lapse, the registry carries adverse findings: New Jersey's testing contractor maintains a 'New Jersey Nurse Aide Abuse Registry' alongside the ordinary registry, and reciprocity into New Jersey is barred to anyone with 'findings of abuse, neglect, or misappropriation of resident property on that state's registry' — so the same standard is applied in both directions. Recertification likewise requires 'No revocation or suspension of a certificate.'",
   "reciprocity": "Two named routes, both sitting on the same three preconditions. The Department: 'If you are certified in another state or U.S. territory, your certification may allow you to work in New Jersey and be placed on the state registry if you satisfy the following: You provide documentation from the state's or U.S. territory's registry that you have a current, valid certificate from the state or territory where you now practice; and You have not been convicted of any crimes and have no findings of abuse, neglect, or misappropriation of resident property on that state's registry; and You meet the requirements of Reciprocity Route 1 or Reciprocity Route 2.' Route 1 — continuing education: 'Within the prior 24 months, you must have completed 24 hours of approved CEUs. These CEUs must include 12 hours of approved continuing education in care for residents with Alzheimer's Disease and other dementia-related disorders, and a total of 12 hours of approved continuing education in the following areas: infection control procedures; emergency procedures; abuse and neglect, and misappropriation of resident property; resident rights; and pharmacy.' Note the weighting — half the hours must be dementia care, which is a New Jersey-specific emphasis. Route 2 — employment, plus both New Jersey exams: 'You must have 24 months of full-time employment in the other state or territory, including at least 35 hours per week, as a CNA performing nursing-related service, supervised by a licensed nurse in a nursing home. The most recent date of such work must be within the 24-month period immediately preceding the date of the application. Route 2 applicants must also pass the New Jersey clinical skills competency examination and the written/oral competency examination.' So Route 2 is not a waiver of testing at all — it is a waiver of the 90-hour course only. How to start: 'Call 1-877-774-4243 to apply for reciprocity' — the Department routes reciprocity applications through its registry contractor's toll-free line rather than through an online form. No reciprocity fee and no processing time is published for either route; both were checked across the Department's nurse aide pages, its payments page and its NATCEP guide. And the neighbouring credential goes the other way: for medication aides, 'New Jersey does not reciprocate with any other state's medication aide program.'",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"New Jersey Department of Health — Nurse Aides/Personal Care Assistants (the certification landing page, Last Reviewed 9/30/2024). Establishes the Department's grouping of the nurse aide and personal care assistant certificates, and links Apply for certification, Renew or replace a certificate, Find a Training Program and NATCEP Workshops.\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/\"}, {\"label\": \"New Jersey Department of Health — Apply for a Certification (Last Reviewed 8/14/2023). Establishes 'Nurse aide certification involves training, practical skills evaluation, a written/oral exam and a criminal background check'; 'The training course is 90 hours, consisting of 50 classroom hours and 40 clinical hours'; the four places to enrol; the three preconditions and the two Reciprocity Routes with their full terms, including the 24 CEU hours with 12 in Alzheimer's and dementia care and the 24-months-at-35-hours-a-week employment test plus both New Jersey examinations; 'Call 1-877-774-4243 to apply for reciprocity'; the five vocational-training and other routes to the examination with '(Clinical skills evaluation is still required)'; the hospital rule ('New Jersey does not require nurse aides to be certified to work in an acute care hospital. However, if a hospital has a licensed long term care unit or a licensed sub-acute unit, certified nurse aides must staff those units'); the UAP curriculum requirement citing N.J.A.C. 8:43G-18.3(e), (f); and the Certification Program's contact details including CNA@doh.nj.gov.\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/apply/index.shtml\"}, {\"label\": \"New Jersey Department of Health — Renew or Replace a Certificate (Last Reviewed 8/14/2023). Establishes 'Renewal and update of your listing on the Registry is required every two years' and the four recertification conditions including 'At least seven hours of paid employment performing nursing or nursing-related services, in a licensed health care facility or agency, within the 24 months preceding your certificate expiration date' and 'A criminal background check, with fingerprinting, prior to the certification expiration date'; the two separate address-change notifications to the Registry (877-774-4243) and to the Criminal Investigations Unit (609-292-4303); and the registry contractor's address for a lost certificate or a reporting-name, address or employer change.\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/nurse-aide-pc-assistant/renew-replace/index.shtml\"}, {\"label\": \"New Jersey Department of Health — Navigating the NATCEP: A Guide to the Nurse Aide in Long-Term Care Facilities Training and Competency Evaluation Program. Version stamp recorded because the document carries no other date: 'All regulatory references in this handbook are current as of October 31, 2006. It is the responsibility of the Nurse Aide Training and Competency Evaluation Program (NATCEP) to ensure that the program is in compliance with all State and Federal rules, statutes, codes, or laws that may have changed since the publication of this handbook.' Establishes the four-part certification description; the approval process for facility, private vocational, community college and county vocational or high school programmes with the $75 check and the three-week lead time; the one-course-then-two-year approval pattern; PSI's contracted role and the fact that it maintains both the Nurse Aide Registry and the Nurse Aide Abuse Registry; the NATCEP materials PSI supplies free within 30 days; the 'Nurse Aide Problems with PSI' escalation procedure; the closed Department curriculum and its four modules; instructor and evaluator workshop requirements and 'Instructors may not evaluate the students they have instructed'; the Director of Nursing rule; on-site monitoring; the $50 curriculum copy and $50 workshop registration figures; the N.J.A.C. 8:39-43.18(d), (e) and (g) fee protections; the mandatory two-step Mantoux before the first day of class; and the two-year NATCEP withdrawal rules.\", \"url\": \"https://www.nj.gov/health/healthfacilities/documents/ltc/navigating_natcep.pdf\"}, {\"label\": \"New Jersey Department of Health — Submit Payments. Establishes the live programme fee schedule under 'Certified Nurse Aide and Certified Medication Aide Programs': Certified Nurse Aide Program Approval Fee ($75), Curriculum Fee ($75), Instructor and Evaluator Fee ($75), CNA Instructor and Evaluator List ($75), Certified Medication Aide Program Approval Fee ($100).\", \"url\": \"https://www.nj.gov/health/healthfacilities/epayments.shtml\"}, {\"label\": \"New Jersey Department of Health — Notice of Adoption, N.J.A.C. 8:39-43.10, 55 N.J.R. 11(1), November 6, 2023 (R.2023 d.123). Establishes the adoption of the amended evaluator qualification without change, the September 21, 2023 filing, the November 22, 2028 expiration date, the two public comments describing New Jersey's former instructor requirements as more stringent than CMS's and as a cause of 'schools across the State having more applicants than available seats for CNA training programs', and the Department's federal standards statement referencing 42 CFR 483.152(a)(5).\", \"url\": \"https://www.nj.gov/health/legal/documents/adoption/NOR%208_39-43.10.pdf\"}, {\"label\": \"New Jersey Department of Health — Notice of Proposal, N.J.A.C. 8:39-43.10. Establishes the full text of the amendment with additions and deletions marked: the evaluator must 'Be licensed in New Jersey as a registered professional nurse' and 'Possess at least one year of full-time or full-time equivalent experience as a registered professional nurse providing care for the elderly or the chronically ill of any age', replacing the deleted three-year facility experience, one-year long-term care experience within five years, and Department evaluator workshop requirements.\", \"url\": \"https://nj.gov/health/legal/documents/notice-of-rule-proposal/NOP%208_39-43.10.pdf\"}, {\"label\": \"New Jersey Department of Health — Notice of Readoption with Technical Changes, N.J.A.C. 8:39, Standards for Licensure of Long-Term Care Facilities. Establishes the chapter's authority ('N.J.S.A. 26:2H-1 et seq., specifically 26:2H-5'), the readoption with technical changes correcting Department and unit names after reorganisation, and the new chapter expiration date of 2028.\", \"url\": \"https://web.doh.nj.gov/apps2/documents/bc/notice_of_readoption_standards_for_licensure_of_long-term_care_facilities_839.pdf\"}, {\"label\": \"New Jersey Department of Health — Statutes, Rules and Rule Proposals (Health Facilities). Establishes the Department's own statement on where the official rules live — 'The official versions of rules, rule proposals and notices of adoptions are published in the New Jersey Administrative Code and the New Jersey Register, which are available in most public libraries or on the web at a free website maintained by Lexis/Nexis' — and its list of the State Long Term Care rule citations including N.J.A.C. 8:39, N.J.A.C. 8:43I and N.J.A.C. 8:36.\", \"url\": \"https://www.nj.gov/health/healthfacilities/rules.shtml\"}, {\"label\": \"New Jersey Department of Health — Certified Medication Aide. Establishes the CMA boundary: that recertification requires being 'currently certified in New Jersey as a CNA, or a CHHA'; the 10 hours of continuing education every two years split five and five; the quoted text of N.J.A.C. 8:36-9.2(d); the employer attestation on Section 2 of the renewal form; the lapsed-certificate email route and the warning that no extension is granted to someone not actively employed; the trainer qualifications; '**Please note that a Certified Medication Aide IS NOT the same as a Certified Medical Assistant'; and 'New Jersey does not reciprocate with any other state's medication aide program.'\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/certified-medication-aide/\"}, {\"label\": \"New Jersey Department of Health — Certified Nursing Aides Portal Training Guide. Establishes the Department's newer online application system and its own description of the programme: 'Certified Nurse Aide (CNA) is a program within the New Jersey Department of Health (NJ DOH) that focuses on approving credentials of individuals who want to practice as a nurse in the State of NJ', and 'Applicant can now be registered and use online portal system to approach department to process respective applications submitting required documentation to get certified.'\", \"url\": \"https://dohlicensing.nj.gov/helpcna\"}, {\"label\": \"New Jersey Nurse Aide Registry — Online Public Registry / Search Licensee Database, operated by PSI for the New Jersey Department of Health. Establishes the four search fields (last name, first name, birth date, certification number) read from the live form, and carries the Department of Health's P.O. Box 358 Trenton address, the toll-free number 1-866-561-5914 and the Department fax number.\", \"url\": \"https://njna.psiexams.com/\"}, {\"label\": \"New Jersey Department of Health — Find a Training Program (the Department's list of approved nurse aide schools).\", \"url\": \"https://www.nj.gov/health/healthfacilities/certification-licensing/DOH%20Approved%20School%202022.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/nj-cna/"
  },
  {
   "page_id": "nm-cna",
   "state": "New Mexico",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "New Mexico Health Care Authority (NMHCA), Division of Health Improvement — Certified Nurse Aide Registry. The Division describes its own role in one line: it 'Operates the Certified Nurse Aide Registry (NAR) and Training program.' Day-to-day testing and the registry software are run by a contractor: 'The New Mexico Health Care Authority (NMHCA) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide tests and scoring services for nurse aide testing.' Before July 1, 2024 the same unit sat inside the New Mexico Department of Health.",
   "board_url": "https://www.hca.nm.gov/certified-nurse-aide-registry/",
   "application_url": "https://nm.tmutest.com/apply",
   "renewal_cycle": "Every 24 months, and what New Mexico asks for is work, verified by an employer — not coursework. 'To maintain eligibility to work, you must renew your eligibility every twenty-four months. To be eligible to renew, you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous twenty-four months.' The Health Care Authority states the same threshold as 'at least 8 paid hours of CNA work within the past 24 months.' The window: 'Renewal requests may be submitted starting 30 days prior to the certification expiration date or up to 30 days past the expiration date' — so there is a 30-day grace period, and it is hard-edged: 'If a CNA goes past the 30-day grace period for renewal, they will need to retake the state competency exam to renew their certification.' How it works: you list your hours and employer in your own account, 'An email verification link will be sent to the employer contact you choose from the list of employers. When the employer verifies your work experience, your eligibility will be extended an additional twenty-four months.' What work counts — and the exclusions matter: qualifying settings are given as 'nursing home, hospital, hospice, home health agency, or ICF/MR facility', while 'Employment as a private-duty aide, doctor's office aide, laboratory aide, personal care home assisted living aide, or personal care home residential living aide does not qualify for recertification.' Agency staff have a special instruction: 'If you work for an employment agency, you must submit your employment verification request to a facility at which you have worked hours through your agency. Employment agencies are not listed in the list of employers and cannot verify your employment.' If a former employer will not confirm the work, there is a state fallback: 'you should choose the HCA Renewal – Documentation Required option, and the New Mexico Health Care Authority (NMHCA) will review and approve your verification.' A disciplinary bar rides on renewal: 'Nurse aides with misconduct restrictions on the Registry are not eligible for renewal.' Notices are electronic only: 'Renewal notifications/alerts are sent via email and text message 30 days before your certification expires. No renewal certifications are sent via USPS mail' — which is why the state repeats that keeping your contact details current in your account is your responsibility.",
   "ce_hours": "The two official New Mexico sources say different things, and both are recorded. The Health Care Authority's Certified Nurse Aide Registry page lists continuing education inside its renewal instructions: 'Certification is valid for 2 years. To renew: Must show at least 8 paid hours of CNA work within the past 24 months. Must complete 12 hours of in-service/continuing education training each year (24 total hours per renewal cycle).' The state-linked New Mexico Nurse Aide Candidate Handbook, which is the document that actually walks a nurse aide through renewal screen by screen, states only the work requirement — 'To be eligible to renew, you must work for pay as a nurse aide performing nursing or nursing-related services at least eight (8) consecutive hours during the previous twenty-four months' — and its renewal flow asks for hours worked and an employer verification, never for course certificates. Neither 8.312.2.21 NMAC nor 8.370.25 NMAC imposes continuing education on the aide; the New Mexico Medicaid nursing-facility rule instead puts the obligation on the facility: 'A NF must furnish regular performance reviews and in-service education to ensure that individuals who serve as nurse aides are competent to perform nurse aide services' (8.312.2.21(A)(4) NMAC). The honest reading is that the 12-hours-a-year figure describes the annual in-service training a nursing facility must provide, which the Health Care Authority has folded into its renewal list; but the Health Care Authority states it as a renewal condition, so a nurse aide should treat the in-service record as something the employer is expected to have. This page reports both and resolves neither.",
   "exam": "Two parts, both required, and the state's own summary is 'The evaluation consists of two tests, a knowledge test and a clinical skills test.' Knowledge test: 'The Knowledge Test consists of 60 multiple-choice questions. Questions are selected from subject areas based on the New Mexico Health Care Authority (NMHCA)-approved New Mexico test plan and include questions from all required categories as defined in federal regulations.' You get 'sixty (60) minutes to complete the 60-question exam', delivered on a computer at the test site — 'All test sites in New Mexico utilize electronic TMU testing using Internet-connected computers' — and the pass mark is stated plainly: 'You must have a score of 74% or better to pass the knowledge portion of the exam.' The published subject-area counts add to the 60: Aging Process and Restorative Care 6, Basic Nursing Skills 6, Care Impaired 2, Communication 6, Data Collection 4, Disease Process 5, Infection Control 6, Mental Health 3, Personal Care 4, Resident Rights 6, Role and Responsibility 6, Safety 6. Language and audio: 'In addition to English, the knowledge and audio knowledge exams are available in Spanish', and a candidate 'can select English or an NMHCA-approved alternate language from a drop-down list. During the exam, you can switch back and forth between your preferred language and English.' An audio (oral) form is available for an extra charge — 'there is an extra $5 charge for the audio version ($45 total), and you must request an Audio version before you submit your testing fee payment' — with the questions 'read to you neutrally and can be heard through wired headphones or earbuds plugged into the computer.' Skill test: performed for an RN Test Observer with a live resident actor for most tasks. 'Each of your randomly selected three (3) or four (4) tasks will have scenarios associated with them', and 'You will be allowed thirty (30) minutes to complete your three or four tasks. After fifteen (15) minutes have elapsed, you will be alerted when 15 minutes remain.' The pass standard is step-level, not a percentage of tasks: 'You must correctly perform all of the critical steps (in bold font) and 80% of all non-key steps on each task assigned to pass the Skill Test.' The first task is always drawn from a mandatory set of four — assisting with a bedpan, catheter care for a female resident, a PPE-and-urinary-drainage-bag task, or perineal care for a female resident — each with hand washing embedded, and 'You will also receive an additional two (2) or three (3) randomly selected tasks.' Catheter care and perineal care are demonstrated on a manikin; everything else is performed on a live actor. Steps that are 'only verbalized or simulated WILL NOT COUNT.' Attempts: three, within 24 months of finishing training, and a failed half can be retaken by itself.",
   "fees": "Testing (paid before a test date can be scheduled, and often paid by the state or the employer rather than the candidate): Clinical Skills Test $100; Written (knowledge) Test $40; Oral/audio knowledge test $45, which the state-linked handbook shows as the $40 knowledge fee plus a $5 audio charge. Taking both parts for the first time is therefore $140. Renewal: 'The renewal fee is $25.00.' Self-payers are charged tax on top — the state-linked handbook's renewal screen says 'the non-refundable renewal fee of $25.00 + a 4.875% non-refundable New Mexico Gross Revenue Tax Fee' — and there is 'no renewal fee for state-funded facilities.' Reciprocity: nothing. 'There is no fee associated with requesting reciprocity in New Mexico.' Test review: $25, and the two official statements of it differ. The testing system's own request form says the candidate 'must submit the $25 non-refundable test review fee and a detailed explanation'. The state-linked candidate handbook calls the same money a deposit and says it can come back: 'If, after investigation, the review finding is in your favor, you will be refunded the $25 test review deposit. If the findings of the review are not in your favor, the $25 test review deposit will stand, and the fee is non-refundable.' Results are emailed within ten business days. Petition to remove a neglect finding from the registry: the request 'shall be accompanied by a payment of $40.00 or a sworn statement of indigence on a form provided by the authority' (8.370.25.23(B) NMAC). Who pays the test fees: 'The State of New Mexico will pay test fees for candidates who have been offered employment or are currently employed by a Medicaid certified nursing facility', with the employer verifying the employment first. Not set by the state: training tuition. The Health Care Authority publishes the list of approved programs and tells candidates to 'reach out to each training program independently for specific pricing and information on course lengths and dates.' Forfeiture rules are real here: arriving late, arriving without a valid signed US government-issued photo ID, arriving with a name that does not match the record, or arriving with guests, children or non-service animals all mean 'you will not be admitted to the exam, and any exam fees paid will NOT be refunded.'",
   "legal_basis": "[{\"citation\": \"42 CFR Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants) — including 42 CFR 483.150, 483.151, 483.152, 483.154, 483.156\", \"what_it_governs\": \"The federal frame every state registry sits inside: state approval of nurse aide training and competency evaluation programs, the minimum curriculum and hours, the competency evaluation, the registry itself, and the findings of abuse, neglect and misappropriation that go on it. The New Mexico Health Care Authority lists these by name on its own Certified Nurse Aide Registry page, singling out '42 CFR 483.152 — Requirements for Approval of Nurse Aide Training and Competency' and 'Part 483, Subpart D'. New Mexico's Medicaid nursing-facility rule points at the same place: a facility 'must comply with nurse aide training requirements as a condition of MAD and MCO enrollment and participation; see 42 CFR Section 483 Subpart D.'\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"8.312.2.21 NMAC (Nursing Facilities — Nurse Aide Training), within 8.312.2 NMAC, Long Term Care Services – Nursing Services, Nursing Facilities\", \"what_it_governs\": \"New Mexico's own rule on nurse aide training as a condition of Medicaid participation: the four-month limit on employing an untrained nurse aide, the 75-hour NATCEP minimum ('The NATCEP program must have a minimum duration of 75 hours'), the 24-month lapse rule sending an aide back to a new NATCEP or competency evaluation, the bar on using temporary nurse aides who have not completed one, the supervision rule for students, the facility's duty to furnish performance reviews and in-service education, the bar on employing anyone convicted of resident abuse, neglect or misappropriation, and the existence of the state registry. ⚠ One sentence of this rule is out of date on its face: subsection C still reads 'DOH maintains a registry of all nursing aides...', naming the Department of Health, although the rule's own issuing-agency section was amended on 7/1/2024 to name the Health Care Authority and the registry moved with it that day.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.312.0002.html\"}, {\"citation\": \"8.370.25 NMAC (Hearing Requirements for Certified Nurse Aides), new and effective July 1, 2024\", \"what_it_governs\": \"What happens when a nurse aide is accused of abuse, neglect or exploitation: the definitions used, notice to the aide and the employing facility, the right to request a hearing in writing within 30 days, an impartial hearing officer, pre-hearing discovery, the 30-day scheduling rule, the survey agency's burden of proof by a preponderance of the evidence, the beyond-your-control defence to a neglect charge, the report to the nurse aide registry within 10 working days, appeal to the first judicial district court in Santa Fe within 30 days, and the petition to remove a neglect finding after one year on payment of $40 or a sworn statement of indigence. The Health Care Authority lists this part by name on its Certified Nurse Aide Registry page.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.370.0025.html\"}, {\"citation\": \"8.370.5 NMAC (Caregivers Criminal History Screening Requirements), new and effective July 1, 2024, implementing the Caregivers Criminal History Screening Act, Sections 29-17-2 to 29-17-5 NMSA 1978\", \"what_it_governs\": \"The criminal-history screening that reaches nurse aides through their employer rather than through certification: who counts as an applicant, caregiver or care provider, fingerprint submission, fees and administrative reconsideration of a disqualifying conviction. It replaced the Department of Health rule at 7.1.9 NMAC, which was repealed effective 7/1/2024. The phrase 'nurse aide' does not appear in it — a nurse aide is caught by the definition of caregiver, 'any person whose employment or contractual service with a care provider includes direct care or routine and unsupervised physical or financial access to any care recipient serviced by that provider.'\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.370.0005.html\"}, {\"citation\": \"Sections 9-8-6(E), 24-1-3(O) and 24-2-5(B) NMSA 1978, as cited by 8.370.25.3 NMAC\", \"what_it_governs\": \"The statutory authority the Health Care Authority names for its certified nurse aide hearing regulations, alongside Section 9-8-1 et seq. NMSA 1978, which 'establishes the health care authority (authority) as a single, unified department to administer laws and exercise functions relating to health care purchasing and regulation.' These sections are recorded because the rule cites them; their own text was not read as of August 16, 2026, so nothing here is quoted or paraphrased from the statutes themselves.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.370.0025.html\"}]",
   "exam_vendor": "D&S Diversified Technologies, LLP (D&SDT) — Headmaster, LLP, under approval from the New Mexico Health Care Authority, delivering the examination and the registry through its TestMaster Universe (TMU) system at nm.tmutest.com. The state names the arrangement directly: 'The State competency evaluation is administered through Headmaster LLP', and the state-linked candidate handbook opens with 'The New Mexico Health Care Authority (NMHCA) has approved D&S Diversified Technologies, LLP (D&SDT)-HEADMASTER, LLP to provide tests and scoring services for nurse aide testing.' This is a change of vendor, not a long-standing arrangement: until July 1, 2024 the New Mexico registry ran on Prometric. Vendors are named here because New Mexico names them; nothing on this page rates or recommends any provider.",
   "training_hours": "75 hours minimum in total, with at least 16 of those hours as supervised clinical training in a nursing facility. Unusually among the states on this site, the number is in a New Mexico rule and not only in agency prose: 8.312.2.21(a) NMAC states that 'The NATCEP program must have a minimum duration of 75 hours.' The Health Care Authority states the same figure two ways on its own page — 'The program consists of a minimum of 75 clocked training hours, including theory and lab hours plus a clinical rotation', and in its step-by-step list 'Federal minimum: 75 hours total (classroom + clinical) training', with the clinical floor given as 'At least 16 hours of supervised clinical training in a nursing facility.' Two things the reader is owed. First, 75 is a floor and real New Mexico programs commonly run longer: the Health Care Authority says 'New Mexico programs usually range from 75–185 hours', so the hours in the course you enroll in are set by that program, not by the state. Second, the state does not publish a classroom-versus-lab-versus-clinical breakdown of the 75 — only the 16-hour clinical minimum — so no split beyond that is stated here. The federal regulation the Health Care Authority points to for program approval is 42 CFR 483.152.",
   "lapse_rule": "Certification lapses if it is not renewed, and the consequences step up with how long it has been lapsed. The federal trigger, as the state-linked handbook relays it: 'Under federal regulations, a nurse aide becomes ineligible for employment if they do not perform at least 8 hours of nursing-related services for pay in a health care setting within each twenty-four month renewal period. To re-establish employment eligibility on the NMNAR, you must successfully pass both components of the approved New Mexico NA nurse aide competency examination.' New Mexico's own Medicaid rule says the same thing in training terms: 'A nurse aide who has not performed nursing or nursing-related services for monetary compensation for a period of 24 consecutive months since completion of a NATCEP must take either a new NATCEP or a new competency evaluation program (CEP)' (8.312.2.21(A)(1) NMAC). The three reinstatement situations, in the state-linked handbook's own division: (1) lapsed less than 24 months — 'you may reinstate your certificate via retesting. Training will not be required if your expiration date is within the past 24 months at the time you apply', arranged by contacting the testing contractor to have the account opened for reactivation by exam, and 'Candidates have 24 months from the date their certification expired to pass both parts of the Competency Examination.' (2) lapsed more than 24 months but still working in the field — 'If your certification has lapsed more than 24 months, but you have been working in a nursing-related field for at least 24 months, you may reinstate your certification via retesting', through the Reactivation by Exam application, supported by 'a letter from your employer on company letterhead' giving name, title, hire dates and a detailed list of job duties; once eligibility is approved, 'You must complete your testing within six months.' (3) lapsed more than 24 months and not working — the hardest case, and the only one that sends you back to school: 'If your certification lapsed more than 24 months ago and you have not worked in a nursing-related field in the past 24 months, you must successfully complete a New Mexico state-approved nurse aide training program and then take and pass the Competency Examination to become certified.' Separately from lapse — misconduct: a substantiated finding of abuse, neglect or exploitation is reported to the registry and blocks renewal outright ('Nurse aides with misconduct restrictions on the Registry are not eligible for renewal'). Only neglect findings can ever be petitioned off: 'A nurse aide may petition the health care authority for the removal of their name from the nurse aide registry in cases where there was a finding of neglect. Petitions for removal will not be accepted when the finding was for abuse, physical or verbal.' The petition may be made 'after one year from the date that they were placed on the nurse aide registry', must show 'that through their employment and personal history their performance as a nurse aide does not reflect a pattern of abusive behavior or neglect; and that neglect involved in the original finding was a singular occurrence', costs $40 or a sworn statement of indigence, and is heard in Santa Fe (8.370.25.23 NMAC).",
   "reciprocity": "New Mexico calls it reciprocity, runs it as an application through the state's testing system, and charges nothing — but it adds a second certification rather than transferring the first. The Health Care Authority is explicit about that: 'Reciprocity grants dual certification. Each state's certification is independent from the other. It is the CNA's responsibility to maintain their certifications for each state.' Eligibility: 'You must be current and in good standing on a nurse aide registry in a state other than New Mexico to be considered.' What you file: the Reciprocity Form application at nm.tmutest.com/apply, with three documents the state lists — 'Government-issued, photo identification or driver's license', 'Social Security Card' and 'Current Out-of-State Nurse Aide Certification.' What happens next: 'Once your completed application and all required documentation have been received, the NMHCA will determine if you are eligible to be added to the New Mexico Nurse Aide Registry', and 'Failure to provide complete and accurate information during the reciprocity determination process may delay or even prevent you from being listed on the NMNAR.' Fee: 'There is no fee associated with requesting reciprocity in New Mexico.' Going the other way — leaving New Mexico: the other state supplies the form, you fill in the top of it, and New Mexico's coordinator verifies and seals it. 'The New Mexico CNA Coordinator will verify the certification in the New Mexico Nurse Aide Registry and will date and stamp the office New Mexico Health Care Authority Department seal. This form can only be sent to the requesting State.' A small conflict in the follow-up time, recorded both ways: the Health Care Authority's page says 'The CNA must follow-up with the Nurse Aide Registry of the requesting state within 2-3 weeks', while the state-linked candidate handbook says 'The CNA must follow up with the NAR of the reciprocating state within 3-4 weeks.' Both are New Mexico's; neither is picked. Not published, and searched for across the Health Care Authority's registry page and the state-linked handbook: any processing time for the reciprocity determination itself, and any route for a person trained out of state who was never placed on any registry.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"New Mexico Health Care Authority — Certified Nurse Aide Registry (the program's own page). Establishes the July 1 2024 move from the Department of Health to the Health Care Authority and the vendor change from Prometric to Headmaster; 'A certified nurse assistant is a certified healthcare paraprofessional...'; the 75-clocked-hour training minimum and the 'At least 16 hours of supervised clinical training in a nursing facility'; 'New Mexico programs usually range from 75–185 hours'; the two-part competency evaluation administered through Headmaster LLP in English and Spanish; 'New Mexico allows up to 3 attempts for each section; within 2 years of completing training'; placement on the registry with a certification number, issue and expiration dates; the two-year term, the 8-paid-hours renewal test and the 12-hours-a-year in-service statement; the 30-days-before-to-30-days-after renewal window and the warning that passing the 30-day grace period means retaking the exam; 'The renewal fee is $25.00'; the test fee table ($100 clinical skills, $40 written, $45 oral); the state-pays-test-fees rule for Medicaid-certified nursing facility employees; the reciprocity documents and 'There is no fee associated with requesting reciprocity in New Mexico'; the outbound verification-form procedure; the regulation list (42 CFR 483.152, NMAC 8.370.25, 42 CFR Part 483 Subpart D); and the registry-search statement 'This site is only to check the NAR.'\", \"url\": \"https://www.hca.nm.gov/certified-nurse-aide-registry/\"}, {\"label\": \"New Mexico Health Care Authority — Division of Health Improvement. Establishes which state unit owns the credential: DHI 'Operates the Certified Nurse Aide Registry (NAR) and Training program', alongside health facility licensing and certification, abuse/neglect/exploitation investigations, the Caregivers Criminal History Screening Program (CCHSP) and the Employee Abuse Registry (EAR), of which it says 'Individuals placed on the EAR are not eligible for hire as caregivers.'\", \"url\": \"https://www.hca.nm.gov/division-of-health-improvement/\"}, {\"label\": \"New Mexico Nurse Aide Candidate Handbook, August 2026, Version 5.0 — the candidate booklet the Health Care Authority links from its own Certified Nurse Aide Registry page as 'New Mexico Candidate Handbook'. Establishes 'The minimum age requirement to test in New Mexico is 16'; the state's approval of D&SDT-HEADMASTER 'to provide tests and scoring services for nurse aide testing'; the definition of the NMNAR and the misconduct findings it carries; the 24-month renewal cycle and the 'eight (8) consecutive hours' work test; the qualifying and non-qualifying employment settings; the employment-agency and unwilling-employer rules; 'Nurse aides with misconduct restrictions on the Registry are not eligible for renewal'; the 30-day post-expiry renewal allowance; the three reinstatement situations and their deadlines; the out-of-state reciprocity conditions; the four training-waiver routes and their six-month testing clocks; 'You have three (3) attempts to pass the exam's knowledge and skill test portions within 24 months'; the 60-question, 60-minute, 74%-to-pass knowledge test with its subject-area counts; the Spanish alternate language and the $5 audio option; the 30-minute, three-or-four-task skill test with its all-critical-steps-plus-80% pass standard and its mandatory-plus-random task structure; the $40/$100/$140 test fee screens; and the '$25.00 + a 4.875% non-refundable New Mexico Gross Revenue Tax Fee' self-pay renewal charge.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/New%20Mexico/forms/NM%20NA%20Candidate%20Handbook%208.2026.pdf\"}, {\"label\": \"New Mexico TMU — the state's nurse aide testing and registry system (home page). The Health Care Authority's designated route for 'All testing, renewal, and reciprocity applications'; the page offers Test Dates, Search New Mexico Registry, Read FAQ and Applications.\", \"url\": \"https://nm.tmutest.com\"}, {\"label\": \"New Mexico TMU — Applications. Establishes the named application routes: the Reciprocity Form ('for applicants who want to be entered on the NMNAR through the New Mexico Reciprocity/Out-of-State registry placement process'); the Nursing Student, Graduate Nurse, Foreign Trained Nurse and Military Training waivers, each described as an application 'to bypass the New Mexico Health Care Authority (NMHCA) training requirement'; Reactivation by Exam (lapsed more than 24 months); the demographic change/correction form; the $25.00 Test Review Request; the ADA Accommodation Request; and the instructor, test site, RN Test Observer, actor and proctor applications that stand up the testing network.\", \"url\": \"https://nm.tmutest.com/apply\"}, {\"label\": \"New Mexico TMU — Public registry search. The live lookup whose own form options establish the four search types listed under Verify a license on this page (Name, SSN, Registration Number, Misconduct), the separate misconduct-list download, and the anti-robot challenge that stands between the form and a result.\", \"url\": \"https://nm.tmutest.com/search\"}, {\"label\": \"8.312.2 NMAC (Nursing Facilities), New Mexico Administrative Code on the State Records Center and Archives site. Establishes 8.312.2.21 in full: the four-month employment limit, 'The NATCEP program must have a minimum duration of 75 hours', the 24-month lapse consequence, the bar on temporary nurse aides, the student supervision rule, the facility's in-service duty, the conviction bar, and 'DOH maintains a registry of all nursing aides who have successfully completed, who have been considered to have completed a NATCEP or CEP program or who have had the NATCEP or CEP requirement waived by New Mexico.' Also establishes that the rule's issuing agency is now the New Mexico Health Care Authority, amended 7/1/2024.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.312.0002.html\"}, {\"label\": \"8.370.25 NMAC (Hearing Requirements for Certified Nurse Aides), New Mexico Administrative Code. Establishes the whole abuse/neglect/exploitation hearing scheme effective July 1 2024, the 30-day window to request a hearing, the report to the nurse aide registry within 10 working days, appeal to the first judicial district court in Santa Fe, and the neglect-only removal petition after one year with its $40 fee or sworn statement of indigence.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.370.0025.html\"}, {\"label\": \"8.370.5 NMAC (Caregivers Criminal History Screening Requirements), New Mexico Administrative Code. Establishes the current caregiver screening rule effective July 1 2024, its scope over 'all applicants, caregivers, hospital caregivers, and care providers in New Mexico', the definition of caregiver, and its statutory basis in the Caregivers Criminal History Screening Act.\", \"url\": \"https://www.srca.nm.gov/parts/title08/08.370.0005.html\"}, {\"label\": \"7.1.9 NMAC (Caregivers Criminal History Screening Requirements) — the repealed Department of Health version, kept in the Administrative Code as a pointer. States that the part 'was repealed, effective 7/1/2024 and was replaced by Health Care Authority rule: 8.370.5 NMAC.' Cited only to fix the date and the successor rule.\", \"url\": \"https://www.srca.nm.gov/parts/title07/07.001.0009.html\"}]",
   "page_url": "https://licensingatlas.com/cna/nm-cna/"
  },
  {
   "page_id": "nv-cna",
   "state": "Nevada",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Nevada State Board of Nursing (the Board issues the CNA certificate itself; Nevada has no separate nurse aide registry agency and no outside registry contractor). The Board describes itself as 'a government agency established by Nevada law to protect the public from unsafe practice by nurses' and notes that it 'is funded from license fees collected from our licensees' and 'does not receive funds from the State General Fund.'",
   "board_url": "https://nevadanursingboard.org/",
   "application_url": "https://nevadanursingboard.org/faq-2/",
   "renewal_cycle": "Every two years, on your birthday, with a work requirement and a continuing-training requirement. 'The certificate of a nursing assistant or medication aide - certified must be renewed biennially on the date of the certificate holder's birthday' (NRS 632.342(1)), and the first cycle runs long or short depending on when you were certified: 'An original license or certificate is valid for the period from the date of issuance to the licensee's or certificate holder's second birthday after issuance' (NAC 632.192(5)). What you must attest to: 'To renew his or her certificate, a nursing assistant must submit to the Board an attestation, on a form provided by the Board, attesting that he or she has completed: (a) Twenty-four hours of continuing training in the immediately preceding 2 years; and (b) At least 40 hours of employment as a nursing assistant under the direct supervision of a registered nurse or licensed practical nurse during the 2 years immediately preceding the date of the renewal of the certificate' (NAC 632.193(1)). The statute requires documentation of both (NRS 632.342(2)(b) and (d)) and adds that the applicant must not have 'committed any acts which are grounds for disciplinary action.' When you can file: 'Renewal applications can be submitted online within 60 days from your current expiration date. If you login to your account beyond the 60-day eligibility period you will not see the renewal links.' The application must reach the Board 'on or before the end of the business day on which the authorization to practice expires' (NAC 632.192(1)). No reminder is sent: 'You will not receive notice of licensure expiration dates or certification renewal dates from the Board. You are responsible for knowing and tracking your certification expiration date.' Fingerprints may be required again: a notification arrives in the portal within 24 hours of the renewal being received, and 'if you are required to fingerprint you will receive a six-month renewal and have a fingerprints required notice in your message center.' After filing: 'It may take up to 72 hours to see your new expiration date.' Renewal takes effect on the latest of the filing date, the payment date, or the date all required information is submitted (NRS 632.342(4)).",
   "ce_hours": "24 hours of continuing training every two years — a real, audited requirement, unlike the registry-only states which impose none. 'The Nevada Nurse Practice Act requires all renewing CNAs to complete 24 hours of CNA-related continuing training within the certificate renewal period. CNAs must also have practiced as a CNA under the direction of a licensed nurse for a minimum of 40 hours per renewal cycle' (Board CNA Renewal FAQs), and the rule behind it is NAC 632.193(1)(a). What counts as a training program, from NAC 632.193(4): it 'must relate to standards of care in nursing and must consist of one of the following: (a) Training in the facility in which the nursing assistant or medication aide - certified works; (b) An academic study or all of the courses required to obtain a license to practice as a registered nurse or a licensed practical nurse, if a nursing assistant or medication aide - certified is pursuing such a license, or both; (c) A workshop conducted by a provider of continuing education that has been approved by the Board; or (d) An online course for nursing assistants or medication aides - certified.' The Board also accepts a provider that 'is an academic institution, has a Nevada continuing education provider number, is approved by another state nursing board or health-related board (includes Boards of Medical Examiners, Pharmacy, and social workers)', or is recognised by the American Association of Critical Care Nurses, the American Association of Nurse Anesthetists, the American Nurse Credentialing Center Commission on Accreditation, the National Association of Pediatric Nurse Associates and Practitioners, or the National League for Nursing. How hours are counted: '60 minutes of participation in CE equals one contact hour'; 'One hour of participation in CNA in-service training equals one contact hour'; and college credit taken toward a higher nursing degree counts at 'one credit (semester) equals 15 contact hours, one credit (quarter) equals 10 contact hours.' What the certificate of completion must show, per NAC 632.193(3): participant name, training program name, number of hours, the instructor's name and signature, and the date and location. You do not file the certificates — you swear to them: 'Rather than requiring CNAs to submit their continuing education/training certificates at the time of renewal, the renewal application asks applicants to affirm (swear) they are in compliance with the continuing education/training requirement and reminds them to retain copies of their certificates for four years in case of an audit. Then, the Board conducts random audits to ensure compliance. Failure to complete the continuing education within the renewal period, or failure to produce evidence of CE/training completion when audited, may result in disciplinary action.' Audits run 'the first of each month', and the 40-hour employment side is audited too — proof is 'a letter written by the employer... on the stationery of the employer or on a form prescribed by the Board' confirming at least 40 hours of paid, supervised service since the last renewal (NAC 632.193(6)). One course is encouraged but not required: 'While the legislature didn't mandate the bioterrorism course for CNAs, the Board highly encourages them to take it as part of their 24-hour continuing education/training renewal requirement.'",
   "exam": "Nevada runs two tests at two different stages, and the attempt rules are different for each. Stage one, at the end of the course: 'upon completion of the program, a nursing assistant trainee must pass a test in theory with an overall score of 80 percent and a test of skills on a pass or fail basis. The test of skills must be given by a registered nurse. If the nursing assistant trainee fails either of the tests, the nursing assistant trainee must repeat the training in the areas in which he or she was deficient before taking the certification examination' (NRS 632.2856(3)). Stage two, the state certification examination, which the Board calls 'the Clinical and Knowledge examinations' in its own application requirements. Three attempts, and failing one part only costs that part: 'Each trainee who graduates from an approved program or an approved program for medication aides - certified may take a competency evaluation test not more than three times' (NAC 632.166); 'A trainee who fails one component of a competency evaluation test is required to retake only that component. A trainee who fails one or both components of a competency evaluation test three times must repeat an approved program. Upon the successful completion of that program, the trainee may reapply to take the competency evaluation test' (NAC 632.169). The statute states the same outcome: 'If an applicant fails the examination three times, the applicant must repeat the training program prescribed in NRS 632.2856' (NRS 632.2858(4)). How you get to the exam: eligibility comes from the Board, not from the school — 'The Board will notify the testing service administering the test of those persons who are eligible to take a competency evaluation test', and the candidate then applies to the testing service directly and pays it (NAC 632.168). The Board sets the pass standard even though it contracts the testing (NRS 632.2858(2)), and it publishes CNA examination pass rates by program on its own site. No question count, time limit or number of skills is published by the Board or in the statute or regulation; all four kinds of official source were checked and none states them, so none is given here.",
   "fees": "$50 to the Board, twice: '$50' for 'CNA by examination' and '$50' for 'CNA by endorsement' among Initial Application Fees, and '$50' for CNA among Renewal Application Fees (Nevada State Board of Nursing Fee Schedule, dated 1/2023). The Board repeats the figure in the application instructions — 'a fee of $50 (MasterCard, Visa, Discover, or American Express debit or credit card). Fees are not refundable' — and refuses refunds after submission: 'once your renewal application is submitted you cannot cancel your application or get a refund. Your application will remain valid for one year should you choose to complete all renewal requirements.' The statute sets a range and the Board sits at the top of it: NRS 632.345 authorises 'Application for a certificate to practice as a nursing assistant or medication aide - certified' at not less than $15 and not more than $50, and a 'Biennial fee for renewal of a certificate' at not less than $20 and not more than $50. A duplicate certificate is priced in the same statute at $5 to $30. No late fee applies to CNAs — the schedule's late fee line reads 'Late fee -- RN/LPN only (Nevada has no grace period) $100', so a CNA pays no penalty but also gets no grace period. Other Board charges on the same schedule: verification of a CNA certification to another jurisdiction, $25 (RN and LPN verifications go through Nursys instead); and fingerprinting, $40 for a hard copy card mailed to the Board, with fingerprints submitted through a private vendor listed as 'Varies'. A 50% discount exists and is easy to miss: 'If you are an active United States military member or the spouse of an active United States military member, a United States military veteran or the spouse or the surviving spouse of a veteran you will qualify for a 50% reduced application fee as long as a copy of your/your spouses military ID or other form of documentation is submitted with your application.' Not paid to the Board: the examination fee, which the candidate pays to the testing service under NAC 632.168 and which the Board's fee schedule therefore does not list; and training tuition, which the state neither sets nor publishes.",
   "legal_basis": "[{\"citation\": \"Nev. Rev. Stat. ch. 632 (Nursing) — Nursing Assistants, NRS 632.285 to 632.2858\", \"what_it_governs\": \"The core of the Nevada CNA credential: the unlawfulness of practising without a certificate and the four-month trainee employment ceiling (632.285); the applicant qualifications, certification by examination and certification by endorsement, and the Board's duty to issue the certificate (632.2852); the 75-hour training programme with no less than 60 hours of theory and laboratory, the instructor qualifications, the 80-percent theory test and pass/fail skills test at the end of the course, the trainee's limited scope, the Board's rulemaking mandate and who may administer a programme (632.2856); and the examination, the Board's authority to contract the testing out while keeping the pass standard, and the three-failure retraining rule (632.2858).\", \"url\": \"https://www.leg.state.nv.us/NRS/NRS-632.html\"}, {\"citation\": \"Nev. Rev. Stat. 632.342 (Renewal of certificate), 632.3425, 632.344, 632.345 (Fees) and 632.347\", \"what_it_governs\": \"Biennial renewal on the holder's birthday, the continuing-training and employment documentation requirements, forfeiture of the right to practise on failure to renew, and when a renewal takes effect (632.342); the rule that a suspended certificate still expires and must be renewed (632.3425); the fingerprint requirement for applicants (632.344); the statutory fee ranges, including $15 to $50 for a nursing assistant certificate application and $20 to $50 for the biennial renewal (632.345); and the grounds for denial, revocation, suspension or other discipline (632.347).\", \"url\": \"https://www.leg.state.nv.us/NRS/NRS-632.html\"}, {\"citation\": \"Nev. Admin. Code ch. 632 — nursing assistant certification and training, NAC 632.166 to 632.193 and NAC 632.721 to 632.805\", \"what_it_governs\": \"On the certification side: the three-attempt cap on the competency evaluation test (632.166), the contents of the certification application including fingerprints (632.167), the Board's notification of the testing service and the candidate's duty to apply and pay the service (632.168), the component-level retake rule and the repeat-the-programme consequence (632.169), the temporary certificate (632.175), lapse of an application (632.185), expiration and renewal including the second-birthday first term (632.192), and the renewal attestation of 24 hours of continuing training plus 40 hours of supervised employment, what counts as a training programme, the four-year record-keeping duty and the Board's random audits (632.193). On the programme side: approval applications and fees (632.721), the determinations required before approval (632.726), general requirements (632.736), required instruction including the 75 hours and the 16 pre-contact classroom hours (632.741), the subject-matter chapters 632.746 to 632.765, instructor numbers and qualifications (632.770, 632.775), classroom and clinical facility requirements (632.780), the coordinator's duties (632.785), records and reports (632.790), periodic review (632.800) and withdrawal of approval (632.805).\", \"url\": \"https://www.leg.state.nv.us/NAC/NAC-632.html\"}, {\"citation\": \"42 CFR Part 483, Subpart D — in particular 42 CFR 483.151\", \"what_it_governs\": \"The federal frame. Nevada's own application instructions require 'a state-approved training program that meets current OBRA requirements', the Board's endorsement form asks the sending state whether the 'Program meets OBRA 1987 Requirements', and the Board's training-programme FAQ states that 'Facility-based programs must also meet federal requirements listed under 42 CFR 483.151(b)' and directs programme operators to review 42 CFR 483.151 to 483.154. The Board links 42 CFR 483.151 directly from its resources page for training programmes.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.151\"}]",
   "exam_vendor": "Credentia — and the whole of Nevada's published evidence for that name is the title of a single page on the Board's own site, 'Credentia Link (Vendor for the State Exam)'. The limit of that source, stated precisely, because it is the most fragile claim on this page: the name appears in that page's title, in its heading and in its own breadcrumb, and nowhere else. The page body is empty — no link, no contact details, no other text of any kind — and despite the word 'Link' in the title it links to nothing. It is also not reachable by browsing: the string 'Credentia' does not appear on the Board's home page, its licensure and certificates page, its FAQ, its education page, its nursing assistant training programs pages or its training-program FAQ, and none of those pages links to it. Checked again on August 16, 2026 with the same result. The page is published (it is in the site's own sitemap) but effectively orphaned, so the Board names its vendor once, in a page title, and explains nothing about it anywhere. The Board's CNA Renewal FAQ refers to the same arrangement without naming it — someone opting to retest 'will receive additional instructions regarding contacting our testing vendor after about approximately one week from the date your application was submitted.' The statutory and regulatory frame confirms the Board contracts the testing out but keeps the standards: 'The Board may employ, contract with or cooperate with any person in the preparation, administration and grading of a uniform national examination, but... shall retain sole discretion and responsibility for determining the standards of successful completion of the examination' (NRS 632.2858(2)), and 'The Board will notify the testing service administering the test of those persons who are eligible to take a competency evaluation test. The applicant must apply to the testing service by the required deadline and submit the appropriate fee' (NAC 632.168). Note the consequence of that second sentence: the examination fee is paid to the testing service, not to the Board, which is why no exam fee appears on the Board's fee schedule. Separately, the program-completion skills test that comes before the state examination is not a vendor product at all — by statute it 'must be given by a registered nurse' (NRS 632.2856(3)).",
   "training_hours": "75 hours of instruction, of which no less than 60 hours must be theory and laboratory. The number is in statute rather than in a handbook, which is unusual among the states on this site: 'The training program required for certification as a nursing assistant must consist of 75 hours of instruction. The program must include no less than 60 hours of theory and learning skills in a laboratory setting' (NRS 632.2856(1)). The Board restates the same requirement in one sentence on its Nursing Assistant Training Program FAQs, joining the statute's two sentences with 'with': 'The training program required for certification as a nursing assistant must consist of 75 hours of instruction with no less than 60 hours of theory and learning skills in a laboratory setting.' Same figures, same effect; only the sentence break differs. The regulation states the same floor with a different breakdown, and both are given here rather than one being merged into the other: 'Each approved program must provide at least 75 hours of instruction which must include: (a) Instruction in the classroom and clinical practice in: (1) The roles and responsibilities of a nursing assistant; (2) Basic nursing; (3) Personal care; (4) The needs of patients concerning mental health and social services; (5) Basic restorative services; and (6) Interrelationships with patients. (b) At least 16 hours of instruction in the classroom, completed before a trainee is directly involved with a patient, in the areas of: (1) Communication and interpersonal skills; (2) The control of infections; (3) Safety and emergency procedures, including, but not limited to, the Heimlich maneuver; (4) Promoting the independence of patients; and (5) Respecting the rights of patients' (NAC 632.741(1)). So the statute caps the non-theory, non-laboratory portion at the remainder of the 75, and the regulation separately fixes 16 pre-contact classroom hours; neither source states a clinical-hours figure of its own, and none is asserted here. What the program must achieve, from NAC 632.736: an approved program 'must enable each trainee to: 1. Learn to react in a sensitive manner to the emotional, social and mental health needs of patients. 2. Communicate and interact competently on a one-to-one basis with patients. 3. Assist patients in attaining and maintaining independence. 4. Learn to exhibit behavior in support and promotion of the rights of patients. 5. Learn skills in observation and documentation.' The detailed content requirements sit in NAC 632.746 through 632.765 — basic nursing skills, personal care skills, mental health and social service needs, care of cognitively impaired persons, basic restorative services, and rights of patients. The primary instructor must give each trainee the programme objectives, the duties and skills expected, unit objectives 'stated in behavioral terms', and 'The criteria used to measure performance' (NAC 632.741(2)). The state publishes no tuition and no unit-by-unit hour schedule.",
   "lapse_rule": "Two separate failures with two different consequences. Failing to renew on time: 'Failure to renew the certificate results in forfeiture of the right to practice unless the nursing assistant or medication aide - certified qualifies for the issuance of a new certificate' (NRS 632.342(3)). There is no grace period — the Board's fee schedule says so in the line that gives RN and LPN holders a late fee and CNAs none: 'Late fee -- RN/LPN only (Nevada has no grace period)'. But the door is not bolted: 'I forgot to submit my renewal application prior to my expiration date, can I still renew? Yes, you can renew at any time but will be required to comply with all renewal requirements before your renewal may be issued', and 'All applicants will have one year to complete all renewal requirements.' Failing the work test is the harder one, because there is no refresher course in Nevada: 'If you have not practiced as a CNA within two years from the date you are submitting your renewal application, you are required to retake a state approved CNA training program OR retake and pass the CNA skills and manual exams before you will be eligible for renewal. There is no CNA refresher program, you are required to complete the entire training program.' The mechanics: file the renewal anyway, answer 'no' to the practice question, then choose retrain or retest — a retester gets instructions about contacting the testing vendor roughly a week later, and a retrainer submits the official certificate of completion when the course ends. A third kind of lapse catches people before they ever hold the certificate: an application 'is valid for one year from the date received by the Board' (and NAC 632.185 governs lapse of an application), and an examination candidate 'must submit an application to Board for certification within one year from the date of completing an approved training program or you will be required to retrain.' Suspension does not stop the clock — 'A suspended license or certificate is subject to expiration and must be renewed' (NRS 632.3425).",
   "reciprocity": "Nevada calls it certification by endorsement, charges the same $50 as certification by examination, and asks for more paperwork than most states. The statute: 'An applicant who is licensed or certified as a nursing assistant in another state may be certified by endorsement if the applicant: (a) Submits a completed written application and the fee required by this chapter; (b) Submits proof of successful completion of a training program approved by the appropriate agency of another state; (c) Has passed a certification examination approved by the Board to be equivalent to the examination required in this State; and (d) Has not committed any acts which would be grounds for disciplinary action if committed by a nursing assistant' (NRS 632.2852(3)). The Board's seven-item checklist adds: a copy of the active out-of-state certificate showing an expiration date; the OBRA-compliant training certificate or a transcript showing completion of 'nursing fundamentals'; fingerprints; and 'Proof employment as a CNA in a licensed medical facility within the past two years', where acceptable proof is a 'Paycheck stub (must include company name); or W-2 form; or A letter from employer on company letterhead, with signature/title of person writing for employer.' Newly certified applicants get a substitute: 'If you are newly certified and have not yet practiced as a CNA, we will accept proof that you have completed your training program within one year from the date your application is submitted as completing this requirement.' The endorsement form goes to your first state, not your current one, and you drive it yourself: 'you must request endorsement from the state in which you held your first CNA certification (your original state). DO NOT mail this form to the Nevada State Board of Nursing... The NSBN will not act as your agent. This is your responsibility.' The form's second half is headed 'To be completed by your original state nurse aide registry only' and asks that registry for the training program name and completion date, whether the 'Program meets OBRA 1987 Requirements', the 'Date initially placed on registry', the certificate number and expiration, the method of certification, whether the person 'Completed a state-approved training program, passed the manual skills and written exam', whether 'there are any registry findings for abuse, neglect, and/or misappropriation', and whether the certificate 'has ever been revoked, suspended, placed on probation, or surrendered.' The Board publishes a directory of every other state's registry phone number on the same form, and marks a long list of states that 'will not complete the Endorsement Form for Certified Nursing Assistant' — for those, 'you will not need to submit the attached endorsement form; however, you must still complete all other application requirements.' Where the original board publishes verification online, 'we will be able to complete the verification process online.' A one-time six-month temporary certificate may be issued while the file is processed.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Nevada State Board of Nursing — Certified Nursing Assistant by Exam Certification Requirements (revised 11/2023). Establishes the five-item checklist, the $50 non-refundable application fee paid through the Nevada Nurse Portal, the OBRA-compliant training certificate or 'nursing fundamentals' transcript, the one-year training-to-application deadline ('or you will be required to retrain'), 'You must successfully pass the Clinical and Knowledge examinations', the required pre-reading of the CNA Skills Guidelines and the CNA Hours of Employment for Renewal Advisory Opinion, the fingerprint requirement and the four-month wait for federal and state results before a permanent certificate issues, the SSN/ITIN requirement, the one-year application validity, the one-week processing estimate, the 30-day address-change duty, 'Nevada does not issue hard card licenses', and 'You will not receive notice of licensure expiration dates or certification renewal dates from the Board.'\", \"url\": \"https://nevadanursingboard.org/wp-content/uploads/2023/11/CNA-Exam-Instructions.pdf\"}, {\"label\": \"Nevada State Board of Nursing — Certified Nursing Assistant by Endorsement Certification Requirements (revised 12/2024). Establishes the seven-item endorsement checklist, the $50 fee, the requirement for a copy of the active out-of-state certificate showing an expiration date, the OBRA training certificate, the two-year proof-of-employment requirement and its three acceptable forms, the substitute for the newly certified, the endorsement form from the first state of certification, the fingerprint rules including 'Federal law prohibits the sharing of fingerprint information', and the one-time six-month temporary license.\", \"url\": \"https://nevadanursingboard.org/wp-content/uploads/2024/12/CNA-Endorsement-Instructions.pdf\"}, {\"label\": \"Nevada State Board of Nursing — Endorsement Form for Certified Nursing Assistant (rev 4/26). Establishes 'The NSBN will not act as your agent. This is your responsibility', the instruction to submit the form 'to your original state nurse aide registry', the state-by-state registry phone directory and the list of states that will not complete the form, and the Part 2 questions the sending registry must answer — training programme and completion date, 'Program meets OBRA 1987 Requirements', 'Date initially placed on registry', certificate number and expiration, method of certification, 'Completed a state-approved training program, passed the manual skills and written exam', 'Are there any registry findings for abuse, neglect, and/or misappropriation?' and whether the certificate has ever been revoked, suspended, placed on probation or surrendered.\", \"url\": \"https://nevadanursingboard.org/wp-content/uploads/2026/04/CNA-Endorsement-Form.pdf\"}, {\"label\": \"Nevada State Board of Nursing — CNA Renewal FAQs (revised 3/2022). Establishes the 60-day renewal window, the $50 renewal fee, the 24 continuing-training hours plus 40 practice hours requirement, the retrain-or-retest consequence of not practising within two years and 'There is no CNA refresher program', the attest-and-retain-for-four-years CE model with random audits on the first of each month, the accepted CE providers and the contact-hour conversions, 'you can renew at any time but will be required to comply with all renewal requirements', the no-refund rule, the 72-hour expiration-date update, and the fingerprint-on-renewal notification and six-month renewal.\", \"url\": \"https://nevadanursingboard.org/wp-content/uploads/2022/03/CNA-Renewal-FAQ.pdf\"}, {\"label\": \"Nevada State Board of Nursing — Fee Schedule (dated 1/2023). Establishes CNA by endorsement $50, CNA by examination $50, CNA renewal $50, 'Late fee -- RN/LPN only (Nevada has no grace period) $100', License/Certification Verification Fees of $25 for a CNA certification with RN/LPN verification 'Completed online at www.nursys.com', fingerprinting fees of $40 for a hard copy card mailed to NSBN and 'Varies' for a private vendor, and the 50% reduced application fee for military members, spouses, veterans and surviving spouses.\", \"url\": \"https://nevadanursingboard.org/wp-content/uploads/2026/02/Fees.pdf\"}, {\"label\": \"Nevada State Board of Nursing — Forms/FAQs/Application Instructions (the Board's application hub). Establishes the CNA document set the Board publishes: CNA Application Requirements for Endorsement, CNA Endorsement Form, CNA Application Requirements for Examination, CNA Renewal FAQ, CNA Employment Verification Sample Letter and CNA Employment Verification Form, alongside the fee schedule, the fingerprint instructions, the criminal-conviction materials and the Nevada Nurse Portal links.\", \"url\": \"https://nevadanursingboard.org/faq-2/\"}, {\"label\": \"Nevada State Board of Nursing — Nursing Assistant Training Program FAQs. Establishes the Board's restatement of the statutory hours ('The training program required for certification as a nursing assistant must consist of 75 hours of instruction with no less than 60 hours of theory and learning skills in a laboratory setting'), the clinical-site and signed-clinical-agreement requirement, the site visit under NAC 632.780(1)-(2), the Commission on Postsecondary Education approval for fee-charging private programmes, the general-supervision rule for facility-based programmes and the director of nursing's prohibition on doing the actual training, and 'Facility-based programs must also meet federal requirements listed under 42 CFR 483.151(b).'\", \"url\": \"https://nevadanursingboard.org/nursing-assistant-training-program-faqs/\"}, {\"label\": \"Nevada State Board of Nursing — Resources for Nursing Assistant Training Programs. Establishes the Board's own pointers to the controlling authority: NAC 632.721 to 632.805 for training programmes, NRS 632.2856 for 'Training Programs; tests; regulations', the Board's CNA Skills Guidelines, 42 CFR 483.151 to 483.154, and the Commission on Postsecondary Education.\", \"url\": \"https://nevadanursingboard.org/resources-for-nursing-assistant-training-programs/\"}, {\"label\": \"Nevada State Board of Nursing — 'Credentia Link (Vendor for the State Exam)'. The Board's own page naming the vendor for the state examination. Recorded as a source and as a limit: the page's published title is the entirety of what it says — the body carries no link, instructions or contact details.\", \"url\": \"https://nevadanursingboard.org/credentia-link-vendor-for-the-state-exam/\"}, {\"label\": \"Nevada Legislature — NRS Chapter 632 (Nursing), revision stamp 'Rev. 4/15/2026 3:47:35 PM--2025'. Establishes NRS 632.285 (unlawful practice, the trainee exception and the four-month trainee employment ceiling, cease-and-desist and law-enforcement referral), 632.2852 (qualifications including age 16 and good moral character, certification by examination and by endorsement), 632.2856 (75 hours with no less than 60 hours theory and laboratory, instructor qualifications, the 80-percent theory test and pass/fail skills test given by a registered nurse, trainee scope, and who may administer a programme), 632.2858 (examination authority, contracting for a uniform national examination while retaining the pass standard, and repeat-the-programme after three failures), 632.342 (biennial birthday renewal and its documentation), 632.3425, 632.344, 632.345 (the fee ranges) and 632.347.\", \"url\": \"https://www.leg.state.nv.us/NRS/NRS-632.html\"}, {\"label\": \"Nevada Legislature — NAC Chapter 632 (Nursing). Establishes NAC 632.166 (three attempts at the competency evaluation test), 632.167 (application contents including fingerprints), 632.168 (Board notifies the testing service; applicant applies to and pays the service), 632.169 (retake only the failed component; three failures means repeating the programme), 632.192 (renewal mechanics and 'An original license or certificate is valid for the period from the date of issuance to the licensee's or certificate holder's second birthday after issuance'), 632.193 (the 24 hours of continuing training and 40 hours of supervised employment, what counts as a training programme, the certificate-of-completion contents, the four-year retention duty and the Board's random employment audits), 632.736 (what an approved programme must enable), and 632.741 (at least 75 hours of instruction and at least 16 hours of classroom instruction before any direct patient contact).\", \"url\": \"https://www.leg.state.nv.us/NAC/NAC-632.html\"}, {\"label\": \"Nevada State Board of Nursing — License / Certificate Verification (public lookup). Establishes the three search modes (name, license number, NCSBN ID), the License Type list including CNA, iCNA, MAC and iMAC, the partial-name guidance, the scope statement ('will verify whether an individual holds an active Nevada nursing license, CNA or MAC certificate and whether disciplinary action has been taken'), the separate route for sending a CNA's status to another board, and the site's own rule that 'You are prohibited from accessing the License Verification Portal with any data mining or automated data gathering extraction tools.'\", \"url\": \"https://nvbn.boardsofnursing.org/licenselookup\"}, {\"label\": \"Nevada State Board of Nursing — Licensure/Certificates (the Board's contact and identity page). Establishes the Board's mission statement, its Reno and Las Vegas office addresses and hours, the toll-free number (888) 590-6726, the general mailbox, and 'The Nevada State Board of Nursing is funded from license fees collected from our licensees. The Nevada State Board of Nursing does not receive funds from the State General Fund.'\", \"url\": \"https://nevadanursingboard.org/licensure-certificates/\"}]",
   "page_url": "https://licensingatlas.com/cna/nv-cna/"
  },
  {
   "page_id": "ny-cna",
   "state": "New York",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "New York State Department of Health (NYSDOH) — Office of Aging and Long Term Care, Bureau of Professional Credentialing (per the live registry page, revised March 2026; the January 2017 training manual places the Bureau under the Division of Nursing Homes and ICF/IID Surveillance); the Nurse Aide Registry and the competency examination are operated under contract by Prometric",
   "board_url": "https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/",
   "application_url": "https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/docs/cna_examination_application.pdf",
   "renewal_cycle": "Every two years, and the test is seven hours of paid work. 10 NYCRR 415.26(d)(6): 'The certified nurse aide shall be recertifed every two years no later than the last day of the month in which certification was received. To obtain recertification the certified nurse aide shall demonstrate in the form indicated by the Department that he/she has worked at least 7 hours for compensation as a health care nurse aide during the previous 24 month period.' Prometric's renewal form repeats the standard and names the setting: 'A Certified Nurse Aide is eligible to recertify if they have worked as a healthcare nurse aide for at least 7 hours within the previous 24-month period prior to their certification expiration date in a health care facility. Health Care Facilities are defined as Health Care Facilities licensed under Article 28 of NYS Public Health Law.' The employer's certification block on that form ties it to the regulation: 'I certify the individual named herein has worked for pay as a nurse aide, under the supervision of a registered nurse, at the Article 28 Facility listed below, for at least seven hours within the previous 24-month period pursuant to 10 NYCRR 415.26(d)(6).' Who files and who pays: the employer, not the aide. The regulation requires that 'The required documentation shall be provided in the form indicated by the Department to each nurse aide who either currently works for or last worked for compensation as a nurse aide in the facility', that no fee be charged to the aide, and that the operator pay the $40 recertification fee — with a staffing agency permitted to pay it instead. Prometric's form has separate blocks for an Article 28 facility employer (nursing home, hospital or D&TC, with an employer code beginning 33-) and for a staffing or employment agency (which must give the Article 28 contractor's name and PFI or operating certificate number, and sign). Not eligible to renew at all: 'Nurse aides with employment restrictions on the registry for resident abuse, neglect, misappropriation of resident property or criminal record disqualifications are not eligible for renewal.' The renewal is mailed with $40 to Prometric's Middle River, Maryland address, and the form warns that it will not be processed without an email address. Note that there is no continuing-education condition on the renewal itself — New York's in-service requirement runs on a separate six-month cycle enforced through the employer (see the continuing-education details on this page).",
   "ce_hours": "Six hours of in-service education in every six-month period — a rolling employer-enforced duty rather than a renewal condition, and the aide must be paid for it. 10 NYCRR 415.26(d)(8)(iv): 'Each certified nurse aide shall attend and be compensated for inservice education sufficient to ensure the continuing competence of the nurse aide of not less than six hours of inservice education in every six month period.' The duty sits on the facility: 'The operator shall ensure that the certified nurse aide regularly attends inservice education programs provided for all personnel.' What it must cover: content is driven by the individual's own review — 'A portion of each individual's annual inservice education... shall be based upon the outcome of the individual's annual performance review... and address the areas of weakness in the individual's performance' — and 'Inservice education must also address the special needs of the residents in the facility, including the care of the cognitively impaired' (415.26(d)(8)(i)-(ii)). Records: 'Written records shall be maintained which indicate the content of and attendance at each inservice training program and the outcomes of the performance review' (415.26(d)(8)(iii)) — kept by the facility, not by the aide. The performance review is a separate, annual requirement: 'The operator shall complete a performance review of each nurse aide at least once every 12 months' (415.26(d)(7)). Note the structural difference from most states: New York does not make continuing education a condition of recertification. Recertification turns on seven hours of paid work in 24 months (see the renewal details on this page); the in-service hours are policed through nursing home surveillance instead, which means an aide who is not currently employed has no one to provide them and no renewal-side consequence for their absence. Neither the regulation, the NYSDOH training manual, the Prometric bulletin nor the recertification form imposes a continuing-education condition on the individual's renewal — all four checked.",
   "exam": "Two parts, both required: 'The New York State (NYS) Nursing Home Nurse Aide Competency Examination consists of two separate parts: the Clinical Skills exam and the Written/Oral exam.' Clinical skills — 'a hands-on skills exam that requires you to demonstrate five skills performed in the care of nursing home residents.' The five are structured: 'While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care. Indirect Care is care related to resident rights and preferences, communication with the resident, resident safety, comfort and needs, and infection control.' Timing varies by skill combination — 'The time allowed for the Clinical Skills exam ranges from 31 minutes to 40 minutes based on the skills you are asked to perform' — and 'To pass the Clinical Skills exam, you must pass all five skills. To pass a skill, you are not required to perform the skill perfectly, but you are required to demonstrate competency of the skill.' Corrections are allowed mid-skill if announced, but 'Once you have completed a skill, you may not go back to correct a previous skill', and 'If a safety issue has occurred, you will not be able to make a correction.' The evaluator checklist is published in advance. Written — 'the Written exam consists of 60 multiple-choice questions that evaluate your overall knowledge and skills in providing safe and competent care.' An oral administration is available and is priced separately; the candidate bulletin notes that 'Candidates applying to take the Oral (audio) Exam do not need to apply for ADA accommodations.' Attempts and order — the regulation puts the skills test first: 'The trainee shall have three opportunities to pass the clinical skills examination', and '(ii) After passing the clinical skills examination, the trainee shall have three opportunities to pass the written or oral competency examination. The nurse aide trainee will obtain certification and be listed in the Registry upon passing the written or oral examination' (10 NYCRR 415.26(d)(4)). The bulletin restates it with the deadline: 'Pass the Clinical Skills exam and the Written or Oral exam within two years of completing your training. You will have three attempts to pass the Clinical Skills exam and three attempts to pass the Written or Oral exam.' A second, shorter clock applies to anyone working while uncertified: 'If the individual has not passed the certification examination within the three attempts and/or within 120 days of their first day of training or employment, the individual may no longer work as a nurse aide trainee in the nursing home.' Results — successful candidates are added to the registry; 'Individuals that are not successful in passing either the clinical skills test or the written/oral test shall receive an official score report that includes diagnostic information by knowledge or content area', and training programs and employing nursing homes receive weekly performance reports on their candidates. Not found in any official New York source we checked: a numeric passing score for the written exam.",
   "fees": "New York's defining fee fact is that an employed nurse aide should pay nothing. The regulation forbids the facility from charging: 'The operator shall not charge a fee to any individual for the costs of training, including textbooks and materials, or for the costs of the competency examinations' (10 NYCRR 415.26(d)(5)), and the same for renewal — 'A fee shall not be charged by the operator to any nurse aide for any cost associated with recertification' and 'The recertification fee... shall be paid by the operator except that the nurse aide staffing agency or employment organization which currently employs the nurse aide may pay this fee' (415.26(d)(6)(ii)-(iii)). The candidate bulletin says the same in plain words: 'Nursing homes must cover all training and exam costs for their employees. If you are not working at a nursing home, you must pay your own exam fees.' A state reimbursement exists for those who paid their own way: 'If you become employed at a nursing home as a nurse aide or get an offer to work in a nursing home as a nurse aide within one year of the completion of your training or exam date, your fees will be repaid by NYS for part of the training and/or exam fee that you paid' — the aide gives receipts to the nursing home, which processes the paperwork, the State pays the nursing home, and the nursing home reimburses the aide; the regulation makes it pro rata 'based on the length of subsequent employment' and caps it at 'the CAP established by the State' (415.26(d)(5)(i)-(ii)). The published fee schedule (Prometric, New York bulletin rev. 11/11/2025): Clinical Skills and Written exams, first-time tester $115; Clinical Skills and Oral exams, first-time tester $135; Clinical Skills Retest $68; Written Retest $57; Oral Retest $67; 'Reciprocity/CNA From Another State and RNs and LPNs' processing $50; Duplicate Certificate $15; 'Recertification (paid by employer)' $40. Payment goes to the state, not the vendor: 'you must send a money order or certified check, made payable to the \"New York State Commissioner of Health, NYNA.\" Fees must be included with the application form. Personal checks and cash are not accepted. Money orders that are older than 30 days will not be accepted as payment', and 'Your name must be on the money order or certified check.' Rescheduling — there is no reschedule fee, only forfeiture: at an in-facility site, 'Contact your facility five full business days before the scheduled exam date to reschedule your exam or your exam fees will be forfeited'; at a regional site, contact Prometric 'at least five full business days before your scheduled appointment'. 'If you are late or miss your exam, your exam fees will be forfeited', though 'You are allowed to take an exam scheduled later in the day without forfeiting your entire exam fee', and a site closure means rescheduling 'without an additional cost'. ⚠ One conflict inside the state's own application form: the New York Certified Nursing Assistant Examination Application (rev. 11/02/2016, hosted on health.ny.gov) prints the reschedule/no-show fees as the full exam amounts ($68 clinical skills, $57 written, $67 oral) and adds a footnote that 'An additional rescheduling/no show fee of $25 is required to reschedule an exam appointment with less than five business days notice' — a $25 charge that appears nowhere in the current bulletin's fee table or narrative. Both are recorded; neither is chosen.",
   "legal_basis": "[{\"citation\": \"10 NYCRR 415.26 (Residential health care facilities — Organization and administration), subdivision (d) 'Nurse aide certification and training'\", \"what_it_governs\": \"The whole New York nurse aide scheme: definitions of the program coordinator, instructor and nurse aide evaluator (415.26(d)(1)); the certification requirement and program approval process (d)(2); the 100-hour training program with at least 30 clinical hours, the required curriculum and the fourth-to-sixth-grade literacy standard (d)(2)(i)); additional training for special-needs populations (d)(3)(i)); the competency evaluation, the independent registered-nurse evaluator and the three-attempts-each rule (d)(4)); the ban on charging trainees for training or examinations and the state reimbursement scheme (d)(5)); two-year recertification, the seven-hours-in-24-months work test, the employer-pays rule and the requalification rules after 24 consecutive months without paid work (d)(6)); the annual performance review (d)(7)); and the six-hours-per-six-months compensated in-service education duty (d)(8)).\", \"url\": \"https://regs.health.ny.gov/content/section-41526-organization-and-administration\"}, {\"citation\": \"10 NYCRR 415.31 (New York State RHCF Nurse Aide Registry), as cross-referenced by 415.26(d)(2)\", \"what_it_governs\": \"The registry itself — 415.26(d)(2) conditions certification on being 'listed in the New York State RHCF Nurse Aide Registry as described in Section 415.31 of this Part'. Section 415.31's own text was not read for this page; it is cited by name only, and every registry fact on this page is quoted from NYSDOH's own registry pages or from Prometric's NYSDOH-contracted materials instead.\", \"url\": \"https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/using_the_nurse_aide_registry.htm\"}, {\"citation\": \"10 NYCRR Part 402 (criminal history record checks), as applied by NYSDOH\", \"what_it_governs\": \"The categories of convictions that disqualify a person from nursing home or home care employment — Class A felonies, Class B or C felonies within the preceding 10 years, listed Class D or E felonies under Penal Law Articles 120, 130, 155, 160, 178 or 220 within 10 years, Penal Law 260.32 or 260.34 offences within 10 years, and comparable offences elsewhere. Part 402's own text was not read; the list is quoted from the NYSDOH-authorised candidate bulletin, which cites 'Department of Health Regulations Title 10, NYCRR Part 402'.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/NY-NA-Bulletin.pdf\"}, {\"citation\": \"N.Y. Public Health Law § 2803-d, as applied by NYSDOH\", \"what_it_governs\": \"The investigation and sustained-finding process for resident abuse, neglect, mistreatment or misappropriation of resident property that is recorded on the registry and bars nursing home employment. The statute's own text was not read; it is cited by NYSDOH on its registry page.\", \"url\": \"https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/using_the_nurse_aide_registry.htm\"}, {\"citation\": \"42 U.S.C. 1395i-3 / 1396r (Social Security Act § 1919), OBRA '87, '89 and '90, as applied by NYSDOH\", \"what_it_governs\": \"The federal frame New York implements. NYSDOH's manual cites § 1919(b)(5) for the rule that nursing homes may not employ or use an individual as a nurse aide or trainee unless listed in good standing on the registry or concurrently enrolled in an approved program, and § 1919(e)(1)-(2) for each state's duty to approve and reapprove nurse aide training and competency evaluation programs. The federal texts were not read for this page.\", \"url\": \"https://www.health.ny.gov/facilities/nursing/docs/nurse_aide_training_program_and_certification.pdf\"}, {\"citation\": \"NYSDOH Dear Administrator Letter DRS #26-04, 'Elimination of Certified Nurse Aide Paper Certificates', dated July 8, 2026\", \"what_it_governs\": \"The end of paper certificates effective August 1, 2026 and the requirement that facilities verify certification status directly through the New York State Nurse Aide Registry from that date. ⚠ NYSDOH's own registry page links this document under the label 'DRS 25-04' while the document itself is numbered DRS #26-04 and the filename is dal_drs-26-04.pdf.\", \"url\": \"https://www.health.ny.gov/professionals/nursing_home_administrator/dal/docs/dal_drs-26-04.pdf\"}]",
   "exam_vendor": "Prometric, under contract to NYSDOH — and in New York the contract covers the registry as well as the exam: 'The New York State Department of Health (NYSDOH) has contracted with Prometric to develop and administer the New York State (NYS) Nursing Home Nurse Aide Competency Examination and manage the NYS Nursing Home Nurse Aide Registry (NAR).' NYSDOH's own manual calls Prometric 'the state's nurse aide testing and registry contractor' and notes that 'The certification examination is administered by registered professional nurses through' that contractor. The people who actually score the skills test are state-designated, not vendor staff in the ordinary sense: 10 NYCRR 415.26(d)(4)(i) requires that 'The clinical skills competency examination shall be given by a licensed registered nurse... who is not otherwise associated with the facility employing and/or training the nurse aide trainee', and that 'Effective July 1, 1992, only individuals possessing nurse aide evaluator designation may administer the State RHCF nurse aide competency examinations.' A Nurse Aide Evaluator must be 'a registered professional nurse who has one year of nursing home experience and has successfully completed the State approved clinical evaluator or nurse aide evaluator program.' Contact points published by NYSDOH and Prometric: Candidate Services 800.805.9128, Recertification/Registry 800.321.6443, Automated Registry 800.918.8818, NYCNA@prometric.com. Prometric is named as subject matter because New York names it; it is not ranked or recommended.",
   "training_hours": "100 clock hours minimum: at least 70 hours of classroom and lab plus 30 hours of supervised clinical training with residents in a nursing home. The regulation states the floor and the clinical share: 'The nurse aide training program shall include classroom and clinical training which enhances both skills and knowledge and, when combined, shall be of at least 100 hours' duration. The clinical training shall as a minimum include at least 30 hours of supervised practical experience in a nursing home' (10 NYCRR 415.26(d)(2)(i)). NYSDOH's own training manual states the 70/30 split explicitly: 'The State-approved NATP requires that each nurse aide trainee receive a minimum of 100 clock hours of training comprised of at least 70 hours of actual classroom and lab training time plus 30 hours of supervised clinical training time with residents in a nursing home.' What does not count toward the 100: 'Actual training time does not include evaluation or testing time, break or meal times', and 'Information relating to facility personnel and general orientation issues for employees, including nurse aide trainees, must be taught in separate and distinct training sessions either prior to or after the successful completion of the nurse aide program.' The floor is a floor, not a ceiling: 'No lesson may be eliminated, reduced, substituted or replaced. The facility may increase the minimum training times for a lesson and/or include additional lessons... In such instances, the NATP would be longer than 100-hours.' Facilities serving special populations must add to it — where a nursing home 'admits special needs residents and/or is certified for pediatrics, ventilator dependent, AIDS or traumatic brain injury (TBI) services, state regulations [10 NYCRR 415.26(d)(3)(i)] require the nursing home to provide additional training specific to the needs of those residents.' Curriculum structure: seven units — Unit I Introductory Curriculum, which the manual marks 'Must be taught first', then Basic Nursing Skills, Personal Care Skills, Mental Health and Social Service Needs, Care of Cognitively Impaired Residents, Basic Restorative Services and Residents Rights — with the 30 clinical hours delivered as 'Training on the resident unit with residents, under the direct supervision of a nurse, other than the unit charge nurse.' Reading level is prescribed, which is unusual: 'This curriculum shall be taught at a fourth (4th) to sixth (6th) grade English literacy level' (415.26(d)(2)(i)). New York therefore sits 25 hours above the federal 75-hour floor.",
   "lapse_rule": "Twenty-four consecutive months without paid nurse aide work ends the certification, and how you get back depends on when you trained. 10 NYCRR 415.26(d)(6)(iv): 'After any period of 24 consecutive months during which the certified nurse aide did not provide nurse aide care for compensation in a residential health care facility, such nurse aide shall be required to requalify as specified in the following subparagraphs (a) or (b) to be listed in the New York State RHCF Nurse Aide Registry: (a) Nurse aides who, on or after July 1, 1989, successfully completed a State approved nurse aide training program in accordance with applicable federal and State requirements, must pass the State authorized residential health care facility nurse aide clinical skills competency examination and the written or oral competency examination; (b) All other nurse aides must successfully complete a State approved nurse aide training program and pass the State authorized... clinical skills competency examination and the written or oral competency examination.' In short: trained on or after July 1, 1989 means retest only; anyone else must retrain and retest. Prometric turns that split into two application routes. Route 6 trained and lapsed: 'Select this certification route if your certification is currently lapsed and you successfully completed a NYS-approved nursing home nurse aide training program on or after July 1, 1989. Your certification is considered lapsed if you have not worked for pay as a NYS nurse aide in the last 24 months at a NYS nursing home or other approved facility.' The applicant gives their NYS certification number and must 'Pass the Clinical Skills exam and the Written or Oral exam within two years of submitting your application', with three attempts at each. Route 7 lapsed - other covers everyone else, whose path runs through a new NYS-approved training program first and then 'Pass the Clinical Skills exam and the Written or Oral exam within two years of the new training completion date.' Note what does not happen in New York: there is no delinquent-but-restorable status and no late fee — the certification simply requires requalification, and the registry is the record. A different and permanent ending comes from a registry finding: a sustained Public Health Law § 2803-d finding of resident abuse, neglect, mistreatment or misappropriation, or a disqualifying criminal conviction, bars employment 'in any capacity in any nursing home' and makes the aide 'not eligible for renewal'; NYSDOH publishes a separate process for Removal of a Finding From the Certified Nurse Aide Registry.",
   "reciprocity": "New York calls it Certification Route 2 — Reciprocity/CNA from Another State — and it is a paperwork route, not an examination route. 'Select this certification route if you are a nurse aide listed in another state's Registry and would like to become certified in New York. To complete route 2, you must: Complete and submit the application form found on Page 44. Provide a copy of your current out-of-state nurse aide certificate(s). If the name on your nurse aide certificate is different from your current name, submit proof of name change (i.e., marriage license). Pay the appropriate fees.' The fee is the $50 line item on the published schedule ('Reciprocity/CNA From Another State and RNs and LPNs' $50). The one condition that catches people: 'If the state in which you are currently certified does not provide expiration dates on its registry, you must provide proof of employment. This must be at least on facility letterhead from your employer. It must indicate that you have worked seven hours for pay in the past 24 months. The letter must state that you have performed nurse aide duties and must be signed by your supervisor.' That mirrors New York's own recertification standard. The examination application also asks every applicant, on every route, to declare out-of-state status and good standing: 'Do you currently hold a certification as a nurse aide or are you listed on the nurse aide registry in any state other than New York? If yes, list all the states below and indicate if you are in good standing on the Registry in that state. Good standing means that you have no findings or convictions of resident abuse, neglect or misappropriation of resident belongings.' A separate and even shorter route exists for nurses: Route 4, for 'a currently active RN or LPN licensed in the United States' — 'You will not be required to complete further training or take the exam'; submit the application with a copy of the current RN/LPN license and the same $50 processing fee. U.S.-trained graduate nurses (Route 3) and foreign-trained nurses (Route 5) skip the training but still sit both exams, and both routes require NYSDOH approval in Albany before Prometric will schedule anything.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"New York State Department of Health — Nurse Aide Registry (the program's consumer home page, revised July 2026). Establishes the official link set: the DRS letter on eliminating paper certificates, the New York State Nurse Aide Registry page, the Prometric verification and 'How to Become a Nurse Aide in New York State' links, the Removal of a Finding page, the four separate lists of approved training programs (DOH nursing-home programs plus three State Education Department categories), the New York Certified Nursing Assistant Examination Application, and the Nurse Aide Registry Renewal Form.\", \"url\": \"https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/\"}, {\"label\": \"New York State Department of Health — New York State Nurse Aide Registry / Using the Nurse Aide Registry (revised March 2026). Establishes that 'The New York State Nurse Aide Registry may be used by anyone, not just health care providers', the IVR telephone verification requiring the certification number, the online verification URL and that it works 'by New York State Nurse Aide Certification number or by name', the registry's content including Public Health Law § 2803-d sustained findings and criminal convictions from October 1, 1990, that 'New information is added, and the Registry is updated daily', the prohibition on employing anyone with such a finding 'in any capacity', and the Bureau of Professional Credentialing contact (1-877-877-1827 option 2, profcred@health.ny.gov).\", \"url\": \"https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/using_the_nurse_aide_registry.htm\"}, {\"label\": \"NYSDOH — New York State Nursing Home Nurse Aide Training Program and Certification (Division of Nursing Homes and ICF/IID Surveillance, January 2017, 215 pages). The state's own curriculum and program manual. Establishes 'The State-approved NATP requires that each nurse aide trainee receive a minimum of 100 clock hours of training comprised of at least 70 hours of actual classroom and lab training time plus 30 hours of supervised clinical training time with residents in a nursing home'; that 'Actual training time does not include evaluation or testing time, break or meal times'; the seven curriculum units with 'Unit I Introductory Curriculum – Must be taught first'; 'No lesson may be eliminated, reduced, substituted or replaced'; the [basic core] PCA/HHA credit; the direct-supervision rule for the 30 clinical hours and that the supervising nurse 'may not be the charge nurse'; the § 1919(b)(5) employment bar and the concurrent-enrolment exception; 'The trainee or candidate is permitted three opportunities to pass the Clinical Skills Test and then three opportunities to pass the Written Test'; the ten-business-day scheduling duty; the 120-day limit on working as a trainee; and the (now superseded) description of certificates and wallet cards arriving by mail.\", \"url\": \"https://www.health.ny.gov/facilities/nursing/docs/nurse_aide_training_program_and_certification.pdf\"}, {\"label\": \"10 NYCRR 415.26 (official regulation text, NYSDOH regs site). Establishes 'The nurse aide training program shall include classroom and clinical training which enhances both skills and knowledge and, when combined, shall be of at least 100 hours' duration. The clinical training shall as a minimum include at least 30 hours of supervised practical experience in a nursing home'; the fourth-to-sixth-grade literacy standard; the program coordinator and nurse aide evaluator qualifications; the independent-evaluator rule and the three-attempts-each structure; 'The operator shall not charge a fee to any individual for the costs of training... or for the costs of the competency examinations' and the state reimbursement scheme; the two-year recertification and the 'at least 7 hours for compensation... during the previous 24 month period' test; the operator-pays and staffing-agency-may-pay rules; the requalification split after 24 consecutive months of non-practice; 'The operator shall complete a performance review of each nurse aide at least once every 12 months'; and 'not less than six hours of inservice education in every six month period'.\", \"url\": \"https://regs.health.ny.gov/content/section-41526-organization-and-administration\"}, {\"label\": \"NYSDOH Dear Administrator Letter DRS #26-04 (July 8, 2026) — Elimination of Certified Nurse Aide Paper Certificates. Establishes that 'effective August 1, 2026, paper certificates will no longer be issued to Certified Nurse Aides', the rationale (undeliverable mail, lost documents, cost, carbon footprint, real-time employer data), and that 'Effective on or after August 1, 2026, facilities are required to verify certification status directly through the New York State Nurse Aide Registry.' Signed by Kristen M. Pergolino, Director, Division of Residential Support, Center for Residential Surveillance.\", \"url\": \"https://www.health.ny.gov/professionals/nursing_home_administrator/dal/docs/dal_drs-26-04.pdf\"}, {\"label\": \"New York Certified Nursing Assistant Examination Application (NYSDOH-hosted PDF, form APPCNANY rev. 11/02/2016). Establishes the seven certification-route checkboxes, the out-of-state registry and good-standing declaration, the training-program and employer certification sections with their 33- prefixed program and facility codes, the in-facility versus regional test site choice, the ADA and oral-exam note ('Candidates applying to take the Oral (audio) Exam do not need to apply for ADA accommodations'), the fee table including the $50 reciprocity/RN-LPN processing fee, and that certified checks are payable to 'New York State Commissioner of Health, NYNA'.\", \"url\": \"https://www.health.ny.gov/health_care/consumer_information/nurse_aide_registry/docs/cna_examination_application.pdf\"}, {\"label\": \"Prometric — New York Nurse Aide Exam program page, the NYSDOH-contracted exam and registry operator, linked by NYSDOH. Establishes 'The New York State Department of Health (NYSDOH) has contracted with Prometric to develop and administer the New York State (NYS) Nursing Home Nurse Aide Competency Examination and manage the NYS Nursing Home Nurse Aide Registry (NAR)'; that 'All individuals performing nurse aide duties in a nursing home on a full-time, part-time or contractual basis must meet minimum training and competency requirements... and be listed in good standing on the NAR'; the two-part exam structure; the August 1, 2026 paper-certificate notice; and the candidate resources including the bulletin, test centre list, clinical skills checklist, renewal application and registry lookup.\", \"url\": \"https://www.prometric.com/nurseaide/ny\"}, {\"label\": \"New York State Nursing Home Nurse Aide Examination Candidate Information Bulletin (Prometric for NYSDOH, revised 11/11/2025). Establishes the seven certification routes in detail including Route 4's 'You will not be required to complete further training or take the exam' and Route 2's out-of-state proof-of-employment condition; the fingerprint CHRC process and that 'There is no charge to you for the cost of the fingerprinting'; the 10 NYCRR Part 402 disqualifying conviction categories; the exam structure ('five skills', 'three assigned skills... Handwashing and Indirect Care', '60 multiple-choice questions', 'ranges from 31 minutes to 40 minutes'); 'To pass the Clinical Skills exam, you must pass all five skills'; the full fee schedule; 'Nursing homes must cover all training and exam costs for their employees'; the one-year state reimbursement route; the 'New York State Commissioner of Health, NYNA' payment instruction and the 30-day money-order rule; the five-business-day rescheduling rule and forfeiture; and the resident-actor requirement at in-facility exams.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/NY-NA-Bulletin.pdf\"}, {\"label\": \"New York State Nurse Aide Registry Renewal form (Prometric for NYSDOH, rev. 02/02/2026). Establishes the $40 renewal fee and mailing address, the eligibility standard ('worked as a healthcare nurse aide for at least 7 hours within the previous 24-month period... in a health care facility. Health Care Facilities are defined as Health Care Facilities licensed under Article 28 of NYS Public Health Law'), the employer and staffing-agency certification blocks with the 33- employer codes and the PFI/operating certificate number, the express citation to 10 NYCRR 415.26(d)(6), and that 'Nurse aides with employment restrictions on the registry for resident abuse, neglect, misappropriation of resident property or criminal record disqualifications are not eligible for renewal.'\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/NY-CNA-Registry-Renewal-Form.pdf\"}, {\"label\": \"New York State Nurse Aide Registry public lookup (Prometric, under NYSDOH contract). The live search form whose own controls establish the search options listed under Verify a license on this page, plus the employer-code note that 'The Dept of Health requires that all employers search the registry prior to employing a Nurse Aide.'\", \"url\": \"https://registry.prometric.com/registry/public\"}]",
   "page_url": "https://licensingatlas.com/cna/ny-cna/"
  },
  {
   "page_id": "oh-cna",
   "state": "Ohio",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Ohio Department of Health — Nurse Aide Registry (Bureau of Regulatory Operations), with training programs licensed by the Department's Bureau of Survey and Certification, Nurse Aide Training and Competency Evaluation Program (NATCEP) unit. Ohio Revised Code 3721.32(A) places the duty on the agency head: 'The director of health shall establish a state nurse aide registry.' The competency examination is delivered under contract: 'The Ohio Department of Health (ODH) has approved D&S Diversified Technologies, LLP (D&SDT) to provide tests and scoring services for nurse aide testing.' No board of nursing is involved in the CNA credential.",
   "board_url": "https://odh.ohio.gov/know-our-programs/nurse-aide-registry",
   "application_url": "https://odh.ohio.gov/know-our-programs/nurse-aide-training-and-competency-evaluation-program-natcep/nurse-aide/nurse-aide",
   "renewal_cycle": "Ohio has no periodic renewal, no expiry date and no renewal fee — and no renewal form to file. What the state has instead is a work test written as a limit on employers rather than as an expiry on the person: 'No long-term care facility is allowed to continue to use as a nurse aide for longer than four months, an individual who previously met the demands of paragraph (B) of this rule but since most recently doing so has not performed nursing and nursing-related services for monetary compensation for twenty-four consecutive months, unless the individual successfully completes additional training and competency evaluation' (Ohio Administrative Code 3701-17-07.1(D)). Read plainly: perform paid nursing or nursing-related services at least once in any twenty-four consecutive months and nothing lapses; go twenty-four months without, and the entry stops working. Note two things the rule builds in. First, the work must be for monetary compensation — the rule's own definition of 'nurse aide' excludes 'an individual who provides nursing or nursing-related services as a volunteer without monetary compensation' (3701-17-07.1(A)(4)). Second, the four-month grace at the front of the rule applies again on the way back: a returning aide may be used for up to four months while participating in the required training or competency evaluation (3701-17-07.1(E)). Keeping the entry right: the Department says the registry 'can assist CNAs with updating their information to show an \"active\" status', and directs registry questions — 'nurse aide registry requirements, lapsed certification, and certification transfer to or from another state' — to the Nurse Aide Registry on (800) 582-5908 in state or (614) 752-9500 out of state. ⚠ The Department's own plain-language 'Nurse Aide Registry Requirements' page, which both its registry page and the state-approved candidate handbook tell readers to consult, could not be located.",
   "ce_hours": "None is published as a condition of remaining on the Ohio Nurse Aide Registry. Ohio's continuing requirement is paid work, not coursework — see the renewal details on this page. Checked and found to impose no continuing-education duty on a listed CNA: Ohio Revised Code 3721.31 and 3721.32; Ohio Administrative Code 3701-17-07.1 (the rule that governs how long a facility may use an aide and what ends that), 3701-18-05 and 3701-18-23; the Department's Nurse Aide Registry, Nurse Aide Training and Establishing a NATCEP pages; and the state-approved Ohio Nurse Aide Candidate Handbook (December 2025, Version 27) in full. Not searched, and named rather than assumed: Ohio Administrative Code Chapter 3701-17 beyond rule 07.1 and the nursing-home licensure rules generally, which is where a facility-side in-service duty would live if Ohio imposes one. This page therefore records the absence of an aide-side continuing-education requirement in the sources read and claims nothing about an employer's in-service obligation.",
   "exam": "Two components, both required: a knowledge test and a hands-on skill test. 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Ohio Nurse Aide Registry.' Knowledge test: '79 multiple-choice questions', 90 minutes, delivered on screen — 'All test sites in Ohio utilize electronic TMU© testing using Internet-connected computers' — with a 15-minute warning. The pass mark is fixed and the state set it: 'You must have a score of 70% or better to pass the knowledge portion of the exam.' Questions come from twelve published subject areas with fixed counts: Basic Nursing Skills 9, Personal Care 9, Safety 8, Mental Health 7, Infection Control 7, Role and Responsibility 7, Care Impaired 6, Communication 6, Older Growth & Development 5, Data Collection 5, Disease Process 5, Resident Rights 5. An audio version is available in which the questions and answers are read through headphones while the candidate reads along. The knowledge exam is in English; word-for-word foreign-language translation dictionaries are permitted, but not dictionaries with definitions or notes and not electronic translators. A remotely proctored option exists for knowledge retakes only. Skill test: 'Each of your randomly selected three (3) or four (4) tasks will have scenarios associated with them', with 35 minutes total and an alert when 15 minutes remain. The scoring rule is strict and asymmetric: 'You must correctly perform all of the critical/key steps (in bold font) and 80% of all non-key steps on each task assigned to pass the Skill Test.' Candidates may correct a step they believe they performed wrongly, and 'All steps must actually be demonstrated. Steps that are only verbalized or simulated WILL NOT COUNT.' A dress code is enforced as an admission condition, not a suggestion: full clinical attire — scrub top and scrub bottom, closed-toe clinically appropriate shoes, long hair pulled back, fingernails no longer than a quarter inch — and 'You will not be admitted for testing if you are not wearing full clinical attire... You will be considered a no-show status. You will forfeit your testing fees.' Identification is equally rigid: a US government-issued, non-expired, signed photo ID and the original Social Security card; 'A letter from the Social Security office will not be accepted' and photocopies, images and digital versions are refused. Arrive 20 minutes early or lose the seat: 'If you arrive late, you will not be permitted to take the test.' After passing: 'your test results will be sent electronically to the Ohio Department of Health by D&SDT-HEADMASTER. Your name will be placed on the Ohio Nurse Aide Registry.' A candidate who disputes a result may file a test review request, which carries a deposit fee.",
   "fees": "Ohio charges no state fee to be listed on the nurse aide registry — the costs are examination fees payable to the Department's testing contractor, on the contractor's Ohio Nurse Aide Candidate Payment Form 1402CND-OH (updated 9-2025) and its December 2025 candidate handbook: Knowledge Exam, or Knowledge Retake, $30.00 per candidate; the optional audio version of the knowledge exam $40.00 (the form shows the arithmetic as '$30 + $10 = $40'); Skill Test, or Skill Retake, $90.00 per candidate. Both components together are $120.00. Additional charges: a $5.00 fax fee if a paper payment form is faxed; a non-refundable $25.00 fee for a replacement CNA card; and a $25 deposit to file a test review request. A no-show earns 'NO REFUND', and the form spells out the commitment — 'BY SUBMITTING THIS FORM, YOU AGREE TO PAY THE TESTING FEES, EVEN IF YOU ARE A NO-SHOW FOR YOUR TEST EVENT.' Payment mechanics: Visa or MasterCard credit/debit online through the candidate's TMU account is the normal path; money order or cashier's cheque via the paper form is 'For special circumstances only'; 'PERSONAL CHECKS AND CASH ARE NOT ACCEPTED.' Fees must be paid before a test date can be chosen. Retakes are partial: 'If this is a re-take test, I must re-test only on the portion I failed' — so a candidate who passed the knowledge test and failed the skill test pays $90, not $120. Who should not be paying at all: a CNA employed by, or holding an offer from, a facility on the day the training programme begins may not be charged for any part of it including the competency evaluation (see requirements). Military: the contractor is 'approved by the Department of Veterans Affairs (VA) as an approved testing vendor for the Ohio NA exam', and an active-duty or retired service member may seek reimbursement of exam fees through the GI Bill using VA Form 22-0803. Not a candidate fee: training tuition, which each licensed programme sets; and the $300 non-refundable application fee a training programme pays to be re-approved (Ohio Administrative Code 3701-18-05(B)(3)).",
   "legal_basis": "[{\"citation\": \"Ohio Revised Code 3721.32 (State nurse aide registry), effective September 30, 2025 (House Bill 96, 136th General Assembly)\", \"what_it_governs\": \"The registry itself: the ten categories of individuals the director must list, including out-of-state registrants and nurses who passed the licensure examination; the inclusion of abuse, neglect, exploitation and misappropriation findings alongside the individual's own disputing statement and the duty to disclose both on inquiry; the registry's status as a public record; and the title protection at 3721.32(E) — 'Only individuals listed on the registry shall use the designation \\\"certified nurse aide\\\" or \\\"CNA.\\\"'\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-3721.32\"}, {\"citation\": \"Ohio Revised Code 3721.31 (Approval of training and competency evaluation programs), effective October 24, 2024 (Senate Bill 144, 135th General Assembly)\", \"what_it_governs\": \"The director of health's power to approve, reapprove, inspect, deny, suspend and revoke nurse aide training and competency evaluation programmes and instructor/coordinator/evaluator training programmes; the bar on approving a programme run by a facility found out of compliance with federal nursing-home requirements in the preceding two years; and the authority to contract with a testing service to administer the competency evaluation, plus the requirement to let career centres, community colleges and similar institutions perform their own competency evaluations where they qualify.\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-3721.31\"}, {\"citation\": \"Ohio Administrative Code 3701-17-07.1 (Required training and competency evaluation for nurse aides working in long-term care facilities)\", \"what_it_governs\": \"The operative employment rule: the definitions of nurse aide, nursing and nursing-related services, long-term care facility and licensed health professional; the four-month allowance and its eight qualifying conditions; the registry-verification duty; the twenty-four-month inactivity rule and what a returning aide must complete; the second four-month allowance on return; and the trainee protections — pre-service hours, personal supervision by a nurse present on the floor, and the trainee name pin.\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-17-07.1\"}, {\"citation\": \"Ohio Administrative Code 3701-18-23 (Eligibility to register for the state-administered test), effective November 1, 2010\", \"what_it_governs\": \"Who may register for Ohio's competency evaluation: nursing students who have completed the basic-skills courses; hospital aides and orderlies with the equivalent of twelve months' full-time employment in the preceding five years, defined as 'at least one thousand six hundred continuous hours in a twelve month period'; and anyone who completed an approved training and competency evaluation programme within the preceding twenty-four months. Also the three-failures rule that blocks re-registration for a component until an approved programme is completed, after which both components must be passed.\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-18-23\"}, {\"citation\": \"Ohio Administrative Code Chapter 3701-18 (Nurse aide training and competency evaluation programs) — including 3701-18-05 (reapproval of a TCEP), effective November 24, 2022\", \"what_it_governs\": \"Programme licensing generally, which the Department names as the source of the 75-hour minimum and the 59/16 split; 3701-18-05 specifically sets the reapproval application, its sixty-day filing deadline and its $300 nonrefundable fee. The particular rule carrying the 75/59/16 hours was not located as of 2026-08-14 — so this chapter is cited as the authority the Department names, not as a quoted source for those figures.\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-18-05\"}, {\"citation\": \"42 CFR Part 483, Subpart D — including 42 CFR 483.152(b)(1) and 483.152(c); and 42 CFR 483.75 on the facility side\", \"what_it_governs\": \"The federal frame: state approval of nurse aide training and competency evaluation programmes, the 75-hour minimum, the 16 hours required before direct resident contact, the registry, and the rule the Department quotes on who may be charged for training — 'no CNA who is employed by, or who has received an offer of employment from a facility on the date on which the CNA begins a NATCEP may be charged for any portion of the program', with pro rata state reimbursement for someone hired within 12 months of completing one.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "D&S Diversified Technologies, LLP (D&SDT), trading as Headmaster LLP — 'D&SDT-HEADMASTER' — under approval from the Ohio Department of Health: 'The Ohio Department of Health (ODH) has approved D&S Diversified Technologies, LLP (D&SDT) to provide tests and scoring services for nurse aide testing.' The Department names the same contractor on its own page as 'D&S Diversified Technologies, the testing vendor for Ohio CNAs' and routes waiver documentation questions to it. Statute authorises the arrangement: the director 'may use a nurse aide competency evaluation prepared by a testing service, and may contract with the service to administer the evaluation' (Ohio Revised Code 3721.31(C)(1)). Scheduling, payment and results all run through the contractor's TestMaster Universe (TMU) system at oh.tmutest.com. The same statute lets some training programmes test their own students: the director 'shall permit a training and competency evaluation program... operated by a career center, community college, or similar educational institution to perform competency evaluations' where it complies with federal law and the evaluation is substantially similar to the director's, and 'A nursing home may proctor a competency evaluation under the circumstances specified in federal laws and regulations' (3721.31(C)(2)).",
   "training_hours": "75 hours minimum, of which at least 16 must be clinical experience in a skilled nursing facility. The Department states the floor on its Nurse Aide Training page: 'Training programs must be no less than 75 hours. Hours must include classroom instruction (some online instruction may be used), skills instruction in the skills lab, and 16 hours of clinical experience in a skilled nursing facility.' Its programme-licensing page gives the full split: NATCEPs 'must be no less than 75 hours in length. Training will consist of at least 59 hours of classroom experience and skills training with at least 16 hours of supervised resident care in a long-term care facility (nursing home only).' Two details worth holding onto. First, the clinical hours are venue-restricted — a nursing home, not a hospital or a home care setting — and the Department writes '(nursing home only)' itself. Second, Ohio permits some of the classroom portion online but says nothing about the skills-lab portion being online, and the clinical hours are on-site by definition. Where the number comes from: Ohio sits exactly at the federal floor of 75 hours, and both figures above are stated by the Department on its own pages under the authority of Ohio Administrative Code Chapter 3701-18. The specific rule text carrying the 75/59/16 split was not located — the rules read (3701-18-05, 3701-18-23, 3701-17-07.1) do not state it, and 3701-17-07.1's own cross-reference for pre-service hours points at a paragraph that no longer exists. So this figure rests on the Department's published statements of its own requirement, not on a quoted rule, and that limit is stated rather than hidden. The one hours figure that does appear in the rules is historical: a pre-1989 grandfathering provision requiring 'at least sixty hours divided between skills training and classroom instruction' plus enough supervised practical training to reach 'the difference between seventy-five hours and the number of hours actually spent' (3701-17-07.1(B)(2)) — evidence that 75 has been Ohio's total since the scheme began, but not a statement of today's requirement.",
   "lapse_rule": "Twenty-four consecutive months without performing nursing or nursing-related services for monetary compensation is the trigger, and coming back costs more than a form. Ohio Administrative Code 3701-17-07.1(D) bars a facility from continuing to use such a person 'unless the individual successfully completes additional training and competency evaluation by complying with paragraphs (D)(1) and (D)(2)' — that is, by doing one of: successfully completing a training and competency evaluation programme; being listed on another state's registry that certifies federal compliance; or meeting the nursing-student or hospital-aide-experience conditions — and, for the training-programme and hospital-experience routes, 'successfully completing the competency evaluation program.' In practice that means a returning Ohio aide re-tests, and one whose route was an ordinary training programme retakes the programme as well. The four-month working grace applies during that period (3701-17-07.1(E)), and a person counts as participating if they hold 'a document signed by a representative of the program attesting that the individual is scheduled to attend the program' (3701-17-07.1(F)). Separately from lapse — abuse findings: the registry carries 'the statement required by section 3721.23 of the Revised Code detailing findings by the director... regarding alleged abuse, neglect, or exploitation of a resident or misappropriation of resident property' along with 'Any statement provided by an individual under section 3721.23 of the Revised Code disputing the director's findings', and the director must disclose both together when an inquiry comes in (Ohio Revised Code 3721.32(B)). The Department publishes an abuse listing separately from the main search. Failing the exam is a third, different path back: three failures of a component blocks re-registration for that component until the candidate completes an approved training programme, after which both components must be passed (Ohio Administrative Code 3701-18-23(B)).",
   "reciprocity": "Ohio recognises an out-of-state CNA by statute rather than by re-examination. The registry must list individuals who 'are listed in a nurse aide registry maintained by another state that certifies that its program for training and evaluation of competency of nurse aides complies with Titles XVIII and XIX of the \"Social Security Act\"... or regulations adopted thereunder' (Ohio Revised Code 3721.32(A)(5)), and the parallel employment rule lets a facility use such a person as a nurse aide on the same basis (Ohio Administrative Code 3701-17-07.1(B)(4)). The Department describes the service in its own words: 'Ohio's Nurse Aide Registry can assist CNAs from other states with moving their registry status to Ohio (reciprocation).' The same route also works as a way back for a lapsed Ohio aide: being listed on a qualifying out-of-state registry is one of the three ways to satisfy the post-24-month requirement (3701-17-07.1(D)(1)(b)). Where to go: the Department directs 'certification transfer to or from another state' questions to the Nurse Aide Registry on (800) 582-5908 (in state) or (614) 752-9500 (out of state), or NAR@odh.ohio.gov. What is not published, and was searched for across the Department's registry, training and NATCEP pages, the state-approved candidate handbook, and Ohio Revised Code 3721.31/3721.32 and Ohio Administrative Code 3701-17-07.1/3701-18-23: no reciprocity application form, no fee, no processing time, and no statement of whether the incoming aide must re-test. The statute's structure implies no re-test — being on a qualifying registry is itself a listing ground — but Ohio does not say so in terms, and this page does not put words in its mouth.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Ohio Department of Health — Nurse Aide Training. Establishes 'An individual who is listed on the Nurse Aide Registry in good standing is referred to as a certified nurse aide (CNA) in Ohio', the three eligibility routes citing Ohio Administrative Code 3701-18-23, 'Training programs must be no less than 75 hours' with the 16 clinical hours in a skilled nursing facility, 'Absences from class and clinical must be made up within 60 calendar days', the settings in which programmes are run and the advice to compare tuition and pass rates, the 1,600-hour hospital-aide and nursing-student waivers with referral to the testing vendor, the federal no-charge and pro rata reimbursement rules with referral to the Ohio Department of Medicaid, and 'Ohio's Nurse Aide Registry can assist CNAs from other states with moving their registry status to Ohio (reciprocation).' Page dated February 14, 2025.\", \"url\": \"https://odh.ohio.gov/know-our-programs/nurse-aide-training-and-competency-evaluation-program-natcep/nurse-aide/nurse-aide\"}, {\"label\": \"Ohio Department of Health — Nurse Aide Registry. Establishes that the registry 'provides a list of all Certified Nurse Aides (CNA) in Ohio' and maintains abuse, neglect and misappropriation findings, that 'Once certified, nurse aides must meet certain requirements to maintain their certification', the three inquiry channels (voice automated system, customer service technician, web-based verification), the separate facility search and abuse listing, and the registry's mailing address, telephone numbers ((800) 582-5908 in state, (614) 752-9500 out of state) and NAR@odh.ohio.gov contact.\", \"url\": \"https://odh.ohio.gov/know-our-programs/nurse-aide-registry\"}, {\"label\": \"Ohio Department of Health — Establishing a Nurse Aide Training and Competency Evaluation Program. Establishes that NATCEPs are licensed by ODH, that they 'must be no less than 75 hours in length' and 'will consist of at least 59 hours of classroom experience and skills training with at least 16 hours of supervised resident care in a long-term care facility (nursing home only)', the 60-day application review and even-month license issuance, the 24-month inspection cycle, and the programme coordinator, primary instructor (Train-the-Trainer) and supplemental instructor requirements. Page dated February 18, 2025.\", \"url\": \"https://odh.ohio.gov/know-our-programs/nurse-aide-training-and-competency-evaluation-program-NATCEP/establishing-natcep\"}, {\"label\": \"Ohio Nurse Aide Registry — public nurse aide search (the Department's own lookup). Establishes the search fields: full registry number for an exact match, or last name and first name or the last four digits of the Social Security number for partial matching.\", \"url\": \"https://nurseaideregistry.odh.ohio.gov/Public/PublicNurseAideSearch\"}, {\"label\": \"Ohio Revised Code 3721.32 (State nurse aide registry), Ohio Laws official site. Establishes 'The director of health shall establish a state nurse aide registry', the ten listing categories including out-of-state registrants at (A)(5) and licensed-nurse deeming at (A)(9), the abuse-findings and disputing-statement disclosure duty at (B), public-record status at (D), and the title protection at (E).\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-3721.32\"}, {\"label\": \"Ohio Revised Code 3721.31 (Approval of training and competency evaluation programs), Ohio Laws official site. Establishes the director's approval, inspection and revocation powers, the two-year non-compliance bar on facility-run programmes, and the authority to contract with a testing service and to permit career centres, community colleges and similar institutions to conduct their own competency evaluations.\", \"url\": \"https://codes.ohio.gov/ohio-revised-code/section-3721.31\"}, {\"label\": \"Ohio Administrative Code 3701-17-07.1 (Required training and competency evaluation for nurse aides working in long-term care facilities), Ohio Laws official site. Establishes the nurse aide and licensed-health-professional definitions, the volunteer exclusion, the four-month employment allowance and its qualifying conditions, the registry-verification duty, the twenty-four-month inactivity rule at (D), the return allowance at (E), the cumulative four-month clock at (G), and the trainee supervision and name-pin rules at (H).\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-17-07.1\"}, {\"label\": \"Ohio Administrative Code 3701-18-23 (Eligibility to register for the state-administered test), Ohio Laws official site. Establishes the nursing-student and hospital-aide eligibility routes with the 1,600-continuous-hours definition, the twenty-four-month recency limit on training-programme completion, and the three-failures-then-retrain rule with the requirement to pass both components afterwards.\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-18-23\"}, {\"label\": \"Ohio Administrative Code 3701-18-05 (Reapproval of a training and competency evaluation program), Ohio Laws official site. Establishes the reapproval application contents, the sixty-day filing deadline and the $300 nonrefundable programme application fee. Cited also because Ohio Administrative Code 3701-17-07.1(H)(1) cross-references a paragraph (A)(4) of this rule that the current text does not contain.\", \"url\": \"https://codes.ohio.gov/ohio-administrative-code/rule-3701-18-05\"}, {\"label\": \"Ohio Nurse Aide Candidate Handbook, D&S Diversified Technologies LLP / Headmaster LLP, December 2025, Version 27 (PDF) — the candidate booklet for the Department-approved examination, linked from the contractor's Ohio CNA page. Establishes 'The Ohio Department of Health (ODH) has approved D&S Diversified Technologies, LLP (D&SDT) to provide tests and scoring services', the two-part exam and the rule that both must be passed, the training-requirement waiver criteria including the 1,600-hour military route, the ADA accommodation process, the two-year testing window and three-attempt limit, the 79-question 90-minute knowledge exam and its 70% pass mark and twelve subject areas, the audio and remotely-proctored-retake options, the 3-or-4-task 35-minute skill test and its all-key-steps-plus-80%-of-non-key-steps standard, the testing attire and identification rules and the no-show forfeiture, the 20-minute check-in, the laminated CNA card and the $25 replacement fee, the $25 test review deposit, and the VA reimbursement and priority-of-service provisions.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/ohio/ohformpages/ohforms/OH%20Candidate%20Handbook%2012.2025.pdf\"}, {\"label\": \"Ohio Nurse Aide Candidate Payment Form 1402CND-OH, D&S Diversified Technologies-Headmaster, updated 9-2025 (PDF). Establishes the fee schedule: Knowledge Exam or retake $30.00/candidate; optional audio version of the knowledge exam $40.00 ($30 + $10); Skill Test or retake $90.00/candidate; a $5.00 fax fee; 'NO REFUND' for a no-show; 'PERSONAL CHECKS AND CASH ARE NOT ACCEPTED'; and the partial-retake rule 'If this is a re-take test, I must re-test only on the portion I failed.'\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/ohio/ohformpages/ohforms/1402CND%20OH%209.2025%20FILLABLE.pdf\"}, {\"label\": \"D&SDT-Headmaster — Ohio CNA Testing and Certification home page. Establishes the current handbook version and effective date, the 70% knowledge pass mark (the page's '7-30-2022- PER ODH' attribution sits in hidden code and is not displayed on the page; the 70% figure itself is live in the candidate handbook), the testing attire and identification notices, the candidate forms (Payment Form 1402, ADA Accommodation Form 1404, Replacement CNA Card Request Form, VA reimbursement form), the nursing-student and hospital-employment training-requirement waiver applications, the Ohio TMU test schedule, and the contractor's separate 'OHIO MA-C' programme heading on its root index (not on this page).\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/ohio/OH_CNA_Home.htm\"}]",
   "page_url": "https://licensingatlas.com/cna/oh-cna/"
  },
  {
   "page_id": "ok-cna",
   "state": "Oklahoma",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Oklahoma State Department of Health (OSDH) — Nurse Aide Registry, within Protective Health Services. The Department's statutory job is stated in its own enabling law: 'The State Department of Health shall have the power and duty to: 1. Issue certificates of training and competency for nurse aides; 2. Approve training and competency programs...; 3. Determine curricula and standards...; 4. Establish and maintain a registry for certified nurse aides and for nurse aide trainees' (63 O.S. § 1-1951(A)). The written examination is delivered by a different state agency — the Oklahoma Department of Career and Technology Education's CareerTech Testing Center, through its Health Certification Project. No board of nursing is involved.",
   "board_url": "https://oklahoma.gov/health/services/licensing-inspections/health-resources-development-service/nurse-aide-registry.html",
   "application_url": "https://oklahoma.gov/health/services/licensing-inspections/health-resources-development-service/nurse-aide-registry.html",
   "renewal_cycle": "Every two years, and the renewal test is paid work — sworn to, and provable on demand. 'A home health aide, long term care aide, ICF/IID care aide, residential care aide, and adult day care aide shall renew individual certification once every two (2) years', and each renewal application requires 'An oath of truthfulness and completeness to be signed by the applicant, affirming that the applicant completed at least eight (8) hours of nursing or health related services for compensation during the preceding 24 months', plus, 'Upon request of the Department, the applicant shall produce documentation of at least eight (8) hours of nursing or health related services performed for compensation during the preceding 24 months' (OAC 310:677-5-2(b)). What counts as proof: the Department's renewal form accepts an administrative signature, a paystub, or a Form W-2, together with the facility's name, address and phone and your start and end dates. What it costs: nothing for a long term care aide; $10 for each of the other categories. How to file it: online through the Department's Long Term Care Digital Application, or on the paper Nurse Aide Renewal Application (ODH Form 717) mailed to the Nurse Aide Registry in Oklahoma City. No continuing education is part of this — see the continuing-education details on this page. Training programs must warn you about this in advance: 'Training programs shall inform the long term care aide, home health aide, ICF/IID care aide, residential care aide, and adult day care aide that they shall complete a new nurse aide training and competency examination or competency examination if, upon applying for renewal of certification, the nurse aide has not provided at least eight (8) hours of nursing or health related services for compensation during the previous twenty four (24) months' (310:677-3-13). One obligation runs to the facility rather than to you, and it is easy to mistake for a renewal condition: a facility 'shall: (1) Complete a performance review of every nurse aide at least once every twelve (12) months and provide two (2) hours of inservice training specific to their job assignment each month' and '(3) Ensure that each nurse aide certification is current and not expired' (310:677-11-1(a)).",
   "ce_hours": "None for the nurse aide credential. Nothing in OAC 310:677-5-2 (renewal), 310:677-3-13 (what programs must tell you about renewal) or the Department's Nurse Aide Renewal Application asks a nurse aide for continuing education; what renewal asks for is the sworn statement of at least eight hours of paid nursing or health-related work in the preceding 24 months, and, for the non-LTC categories, $10. Sources checked and found not to impose continuing education on a nurse aide: OAC 310:677 in full (all nine subchapters), 63 O.S. §§ 1-1950.1 to 1-1951, the Department's Nurse Aide Registry page, and ODH Form 717 (revised 12/2023). Two nearby requirements are real and are not the aide's. First, the facility must 'provide two (2) hours of inservice training specific to their job assignment each month' and complete an annual performance review of every nurse aide, with in-service education 'generally supervised by a registered nurse who has at least two (2) years nursing experience, at least one (1) year of which shall be in the provision of long term care services' (OAC 310:677-11-1(a)). That is a condition of the facility's compliance, not of your certification. Second, the certified medication aide — a different credential — does carry continuing education, and the rule states it directly: 'A certified medication aide shall complete at least eight (8) hours of continuing education every twelve (12) months, excluding the first year of certification, from a State approved program. A record of successful completion shall be kept in the certified medication aide's personnel file' (OAC 310:677-13-1(b)), repeated as a renewal condition at 310:677-13-1(d)(1). The Department's renewal form says the same thing in its own words, requiring the CMA to 'Attach documentation of continuing education equivalent to eight (8) hours for every twelve months of certification, excluding the first year of certification', and adds that 'Continuing Education Units (CEUs) must be completed during the certification period or within one year after that.'",
   "exam": "Two parts, both required, with separate pass standards. 'An individual shall pass both the written or oral examination and the skills examination to complete the competency examination successfully. An individual shall score at least seventy (70) percent on the written or oral examination. An individual shall demonstrate at least eighty (80) percent accuracy for the skills examination' (OAC 310:677-3-11). Written or oral — the choice is yours but the language is not: the written portion is given 'in English', and it must 'Allow a nurse aide to choose between a written and an oral examination'; if oral, 'the examination portion shall be read from a prepared text in a neutral manner.' The questions must 'Be developed from a pool of test questions, only a portion of which is used in any one (1) examination', and the process must prevent disclosure of both the question pool and individual results (310:677-3-10(a)). Skills: it must 'Consist of randomly selected items drawn from a pool of tasks generally performed by nurse aides' and 'Be performed in an entity in which the individual will function as a nurse aide or a similar laboratory setting.' What you bring to the written test, per the state testing centre: an 'Original Training Verification Form signed by the training program supervisor or approval letter from NAR'; a 'Valid, current photo identification issued by government entity within the U.S.'; and proof of your Social Security number (card, Social Security Administration letter, W-2 or official tax return) — 'If unable to provide proof of SSN, a SSN Attestation Form must be completed.' You may test somewhere other than where you trained: 'The trainee may sit for the written or oral examination and skills examination at a different location than where training was completed if the testing entity is provided with a Training Verification Form.' Attempts: a failing candidate must be told 'The areas which the individual did not pass' and 'That the individual may retake the examination a total of two times without further training' (310:677-3-12). Results and the registry: the testing entity must be capable of 'providing competency results in the proper format for compatibility with the Department's nurse aide registry within thirty (30) days of scoring', and 'The Department shall include in the nurse aide registry a record of successful completion of the competency examination within thirty (30) days of the date the individual is found to be competent.' Oklahoma publishes a Certified Nurse Aide Study Guide and practice scenarios through its testing centre.",
   "fees": "The long term care aide — the credential most people mean by CNA — is free on the state side, and Oklahoma says so three separate ways. On a new application: 310:677-1-3(f) sets the fees for the routes onto the registry that do not run through an approved Oklahoma training program — deeming, home health aide reciprocity, training exceptions and the program waiver — and then names who pays: 'The fees specified in (1) through (4) of this subsection apply to applications for home health aides, certified medication aides, ICF/IID care aides, residential care aides, and adult day care aides. A fee shall not be charged on an application requesting certification as a long term care aide only' (OAC 310:677-1-3(f)(5)). On a card: 'A fee shall not be charged on an application requesting a duplicate or amended long term care aide certification card' (310:677-1-3(h)). On renewal: the $10 renewal fee is imposed on 'a home health aide, ICF/IID care aide, residential care aide, or adult day care aide' (310:677-5-2(c)) — a list that leaves the long term care aide out — and the Department's own renewal form carries the checkbox 'LTC – No Fee.' The other categories do pay. Renewal: $10 each for home health aide, ICF/IID care aide, residential care aide, adult day care aide, feeding assistant and certified medication aide (OAC 310:677-5-2(c); ODH Form 717). Deeming applications: $15 each, except 'Home Health Aide deemed to Long Term Care Aide with no fee required.' Home Health Aide Reciprocity Application: $15. Training Exception or Foreign Graduate Training Exception Application: $15. Nurse Aide Training and Competency Evaluation Program Waiver Application: $15. Certified Nurse Aide Retest Application: $15 when submitted 'by a home health aide, ICF/IID care aide, residential care aide, or adult day care aide.' Duplicate or amended certification card: $10. All of them are non-refundable, and the Department repeats that on its own form: 'All Fees submitted are NON-Refundable.' The statutory ceiling: 'Each person certified as a nurse aide pursuant to the provisions of this section shall be required to pay certification and recertification fees in amounts to be determined by the State Board of Health, not to exceed Fifteen Dollars ($15.00)' (63 O.S. § 1-1951(B)(1)) — which is why no fee on this page is larger. Examination fees are not published by the state and are not paid to the state: 'Candidate must pay testing fees to the test site upon registration. For information about testing fees or to schedule an exam, please contact a HCP test site' (CareerTech Testing Center). Neither the Department nor the testing centre publishes an amount, so none is stated here. A separate fee that falls on facilities, not aides: a nursing facility applying for a temporary emergency waiver pays 'a non-refundable fee of one hundred dollars ($100)' initially and '$75' for a subsequent waiver (310:677-1-6(c)(7)-(8)). Not set by the state: training tuition; the Department publishes the approved-program list but no prices, and notes that 'Any program marked (locked) requires enrollment in another program on the campus and cannot be taken by itself.'",
   "legal_basis": "[{\"citation\": \"63 Okla. Stat. § 1-1951 (Power and Duties of State Department of Health — Certified Nursing Aides), within the Nursing Home Care Act\", \"what_it_governs\": \"The whole Oklahoma nurse aide scheme: the Department's duty to issue certificates of training and competency, approve training and competency programs, determine curricula (including 'a minimum of ten (10) hours of training in the care of Alzheimer's patients'), establish and maintain the registry for certified nurse aides and trainees, set categories and standards including feeding assistants, and suspend or revoke certification. It also caps certification and recertification fees at $15, protects the title 'Certified Nurse Aide' and the abbreviation 'CNA', deems a certified nurse aide qualified to work as a home health aide under the Home Care Act, and prescribes what the registry must contain, the ten-working-day deadline for entering a substantiated finding, and the removal of a pending notation within 24 hours when an allegation is unsubstantiated.\", \"url\": \"https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=98638\"}, {\"citation\": \"63 Okla. Stat. § 1-1950.1 (Definitions — Criminal History Background Checks — Exemptions)\", \"what_it_governs\": \"Who counts as a nurse aide and as an employer for these purposes; the employer's duty to obtain a criminal history background check before making an offer; the temporary-employment-pending-results rule and the 72-hour reporting duty; acceptance of a report less than a year old from a previous employer with written consent; and the list of convictions that bar hiring outright, including abuse, neglect or financial exploitation of a person entrusted to the applicant's care, rape, incest, sodomy, child abuse, murder or attempted murder, manslaughter and kidnapping.\", \"url\": \"https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/protective-health/hrds/nurse-aide-registry/63-os-1-1950.1-63-1-1951-nurse-aide-certification-11-1-2017.pdf\"}, {\"citation\": \"63 Okla. Stat. §§ 1-1950.4 and 1-1950.4a (Uniform Employment Application for nurse aide staff)\", \"what_it_governs\": \"The mandatory statewide employment application for facilities that use nurse aide staff, effective November 1, 2012, and the misdemeanour created by falsifying a criminal conviction on it. The Department names both sections and quotes the operative language on its Nurse Aide Registry page; the sections' own texts were not read as of August 16, 2026, so nothing here is quoted from the statutes themselves beyond what the Department reproduces.\", \"url\": \"https://oklahoma.gov/health/services/licensing-inspections/health-resources-development-service/nurse-aide-registry.html\"}, {\"citation\": \"Okla. Admin. Code Title 310, Chapter 677 (Nurse Aide Training and Certification), edition published September 2023\", \"what_it_governs\": \"Everything operational, across nine subchapters: definitions; applicability and the employer's duty to consult the registry; training exceptions, nurse waivers, foreign-graduate exceptions, deeming, retest applications and their fees; temporary emergency waivers for facilities; approval, review and withdrawal of training programs; criminal-history duties of programs; administration and content of the competency examination and its 70% written and 80% skills pass standards; the two-retakes-without-retraining rule; registry operation, the two-year renewal cycle and the eight-hours-of-paid-work test; automatic removal after 48 months and the two exceptions to it; denial, suspension, withdrawal and nonrenewal of certification and their minimum durations; the hearing process; and separate subchapters of training standards for home health aides (677-9), long term care aides (677-11), certified medication aides (677-13), ICF/IID care aides (677-15), residential care aides (677-17) and adult day care program aides (677-19). Most sections carry 'Amended at 40 Ok Reg 1588, eff 9-11-23' as their newest history line.\", \"url\": \"https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/protective-health/long-term-care-services/forms/current/rules-and-regs/Chapter%20677%2009.2023.pdf\"}, {\"citation\": \"42 CFR Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants) — including 42 CFR 483.151, 483.152 and 483.154\", \"what_it_governs\": \"The federal frame Oklahoma's rules import directly: 42 CFR 483.152(b)(2)-(7) supplies the required curriculum subjects for the long term care aide program by cross-reference, and 42 CFR 483.154 supplies the competency examination standard. The Department states its own federal role on the same page: 'The Nurse Aide Registry is contracted by the Centers for Medicare and Medicaid Services to review and approve Nurse Aide Training Programs (NATP)', that under 42 CFR 483.151(b)(1)(iii) 'in all reviews other than the initial review, the State must visit the entity providing the program', and that 'The State may not grant approval of a NATP for a period longer than 2 years as specified in 42 CFR § 483.151(d).'\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Two different bodies, which is what makes Oklahoma unusual. The written examination is delivered by another state agency: the Oklahoma Department of Career and Technology Education's CareerTech Testing Center, through its Health Certification Project, which publishes the exam codes itself — 'Long Term Care - 7C; Home Health Care - 5A; ICF/IID Care - 2A (formerly Developmentally Disabled Care); Adult Day Care - 3A; Residential Care - 4A' — and the Oklahoma State Department of Health links its list of testing sites from the Nurse Aide Registry page. The skills examination is delivered locally rather than by a single vendor: 'The competency examination shall be administered and evaluated only by a Department approved entity which shall be periodically monitored by the Department' (OAC 310:677-3-9(a)), and the skills portion must 'Be administered and evaluated by a qualified clinical skills observer' (310:677-3-10(b)(3)) — a role the rules define as 'a registered nurse, qualified intellectual disability professional, licensed practical nurse, registered pharmacist or other qualified professional who has at least one (1) year experience and has successfully completed a Department approved clinical skills observer training program.' Facility proctoring is permitted but fenced: if the Department lets entity personnel proctor, the procedures must ensure the examination 'Is secure from tampering', 'Is standardized and scored by a testing, educational, or other organization approved by the Department', and 'Is transmitted to the scoring entity immediately after completion' — and 'The Department may revoke the approval of an entity to proctor the nurse aide competency examination if the Department finds evidence of impropriety, including evidence of tampering by facility staff.' No private vendor is named by the state for the nurse aide competency examination, and this page names none.",
   "training_hours": "At least 75 hours 'or the equivalent' for a long term care aide, with three specific components inside and on top of it. The rule states them together: 'The training program for long term care aides shall include: (1) At least, seventy-five (75) hours of training or the equivalent. (2) At least sixteen (16) hours of training in the following areas prior to any direct contact with a resident that is documented and signed by the nurse aide trainee: (A) Communication and interpersonal skills. (B) Infection control. (C) Safety and emergency procedures, including the Heimlich maneuver. (D) Promoting a resident's independence. (E) Respecting a resident's rights. (3) At least sixteen (16) hours of supervised practical training that is documented and signed by the nurse aide trainee' (OAC 310:677-11-4(a)). The Oklahoma-specific addition, and it is statutory rather than merely regulatory: 'Pursuant to 63 O.S. § 1-1951(A)(3), the long term care aide training program shall include a minimum of ten (10) hours of training in the care of Alzheimer's patients' (310:677-11-4(c)). The statute says the same thing from the Department's side: it must 'Determine curricula and standards for training and competency programs. The Department shall require such training to include a minimum of ten (10) hours of training in the care of Alzheimer's patients.' The remaining subject matter is imported wholesale from the federal rule: the program 'shall include the subjects specified in paragraphs (b)(2) through (7) of 42 CFR 483.152(b)' — basic nursing skills, personal care skills, mental health and social service needs, care of cognitively impaired residents, basic restorative services, and residents' rights. Two things the reader is owed. First, 'or the equivalent' is the rule's own wording and Oklahoma does not publish a classroom/lab/clinical split of the 75 hours beyond the two 16-hour floors. Second, the other aide categories have different curricula entirely — home health aide at 310:677-9-4, ICF/IID care aide at 310:677-15-3, residential care aide at 310:677-17-3 and adult day care aide at 310:677-19-3 — so an hours figure quoted for 'Oklahoma nurse aides' without naming the category may be describing a different credential.",
   "lapse_rule": "Oklahoma's lapse rules are graded by how long you have been out, and the sharpest edge is at four years. The 24-MONTH work rule, which is what usually ends a certification: 'If any nurse aide requests renewal of certification and there has been a continuous period of twenty-four (24) consecutive months during none of which the individual provided nursing or health related services for monetary compensation, the individual shall complete a new training and competency evaluation or a new competency evaluation program, whichever option they choose, to become recertified' (OAC 310:677-5-4(a)). The retest route, and the three ways to qualify for it: a person who previously completed an approved program 'and is unable to renew certification may obtain approval to take a retest by filing a Certified Nurse Aide Retest Application' where any one of these is true — no eight hours of paid nursing or health-related services in the 24 months before expiry; none in the 24 months after expiry; or 'The individual's nurse aide certification has been expired for over two (2) years but less than three (3) years' (310:677-1-3(g)). The retest is not unlimited: 'An individual who fails the approved retest shall be required to retrain before taking any subsequent retests.' The four-year cliff: 'The Department shall automatically remove a nurse aide from the nurse aide registry and place them in the archive database if there has been a continuous period of forty-eight (48) consecutive months in which the nurse aide has not applied for renewal of certification. The individual shall complete a new nurse aide training and competency examination to be reinstated in the registry' (310:677-5-4(d)) — with one carve-out that runs the other way: 'a nurse aide with a pending or permanent finding of abuse, neglect, mistreatment, or misappropriation of property shall not be removed from the registry.' Two exceptions that can save a lapsed aide. If you went to nursing school instead: the Department 'may grant an exception in removing any nurse aide from the nurse aide registry... if the nurse aide has completed a practical or registered nursing education program after certification', on a waiver application plus verification that you are in good standing with the Oklahoma Board of Nursing, are not under investigation, have no confirmed abuse or neglect finding, and have no restriction preventing you from sitting the nursing board exam (310:677-5-4(b)-(c)). If you were working somewhere that does not certify: the Department 'may grant an exception to place an individual, who failed to renew certification, back on the registry if the individual can produce documentation of continuous employment for the past forty-eight (48) months in a hospital, the Advantage Program through the Department of Human Services, or an entity that does not require certification of nurse aides' (310:677-5-4(e)). Discipline is separate from lapse: the Department may deny, suspend, withdraw or refuse to renew a certification for grounds including intentionally providing false information, failing to provide care as ordered 'with resulting actual harm that is either life threatening or has a negative outcome for the resident', altering or falsifying medical records or a nurse aide identification card, or 'Representing oneself as a certified nurse aide without supervision by a licensed health Professional and providing services that are not included in a Department approved nurse aide training and competency evaluation program' (310:677-5-5(b)). The minimum durations are fixed: 'The suspension of a certificate shall be for at least six months. A denial, withdrawal or nonrenewal of a certification shall be for at least one year.' A finding of abuse, neglect, mistreatment or misappropriation goes on the registry only after the aide has been offered a hearing — and if no written hearing request arrives within 30 days of the notice, the finding is entered (310:677-7-1).",
   "reciprocity": "Oklahoma grants it by application, and for the long term care aide it costs nothing. The rule, in one sentence: 'An individual may apply for listing in the nurse aide registry by reciprocity from another State and the Department may approve such application if the individual is listed in another State registry as a certified long term care aide and does not have a notation of abuse, neglect, mistreatment, or misappropriation of property' (OAC 310:677-11-1(b)). The rules define the word the same way — 'Reciprocity means the process that allows a certified nurse aide from another state to be listed in the Department's nurse aide registry.' How you file it: the Department publishes two routes on its Nurse Aide Registry page — a digital 'Long Term Care Reciprocity' application, and a paper 'Home Health Aide Reciprocity' application (ODH Form 735). What it costs: the Home Health Aide Reciprocity Application carries a $15 non-refundable fee (310:677-1-3(f)(2)); the long term care aide pays nothing, because 'A fee shall not be charged on an application requesting certification as a long term care aide only.' Note the two conditions and what they leave out: the rule asks that you be listed in another state's registry as a certified long term care aide and that you carry no abuse, neglect, mistreatment or misappropriation notation. It does not, in its own text, require that the out-of-state listing be currently active, and it sets no processing time. Not published, and searched for across OAC 310:677 in full, 63 O.S. §§ 1-1950.1 to 1-1951, the Department's Nurse Aide Registry page and its renewal and reciprocity forms: any processing time for a reciprocity decision, and any route for a person trained out of state who was never placed on any registry — although the Training Exception Application, which accepts an official transcript showing classroom and clinical training equal to or greater than Oklahoma's, is the nearest published path for that person.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Oklahoma State Department of Health — Nurse Aide Registry (the program's own page). Establishes the applications and forms set (renewal, reciprocity, RN/LPN training waiver, US and foreign training exceptions, CNA and CMA retest, deeming, affidavits of lawful presence, uniform employment application, abuse notification); the deeming table across all five aide categories; the Uniform Employment Application mandate and the misdemeanour for false conviction information; the rules-and-statutes list (OAC 310:677, 63 O.S. §§ 1-1950.1 to 1-1951, the complete Nursing Home Care Act and Long Term Care Security Act); the barrier-offence date of November 1, 2012; the Department's CMS contract to review and approve training programs and the two-year approval limit; the approved-program list and its '(locked)' note; the link to the CareerTech testing sites list; and the 'Verify A Nurse Aide' and abuse-registry lookups.\", \"url\": \"https://oklahoma.gov/health/services/licensing-inspections/health-resources-development-service/nurse-aide-registry.html\"}, {\"label\": \"Okla. Admin. Code Title 310, Chapter 677 (Nurse Aide Training and Certification), September 2023 edition PDF, published by the Oklahoma State Department of Health and linked from its Nurse Aide Registry page as 'Nurse Aide Training and Certification Rules OAC 310:677'. Establishes the 75-hour long term care aide training minimum with its two 16-hour floors and the statutory 10 hours of Alzheimer's training; the definitions of clinical skills observer, deeming, reciprocity and waiver; the employer's duty to consult the registry; the $15 and $10 fee schedule and the long-term-care-aide fee exemptions; the retest criteria and the retrain-after-a-failed-retest rule; the competency examination administration, content, 70%/80% pass standards and two-retakes rule; the 30-day registry entry deadline; the two-year renewal cycle and the eight-hours-of-paid-work oath; automatic removal after 48 months and the nursing-school and non-certifying-employer exceptions; the discipline grounds and minimum durations; the 30-day hearing window; and the temporary emergency waiver with its $100/$75 fees and six-month cap.\", \"url\": \"https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/protective-health/long-term-care-services/forms/current/rules-and-regs/Chapter%20677%2009.2023.pdf\"}, {\"label\": \"63 Okla. Stat. § 1-1951 (Power and Duties of State Department of Health — Certified Nursing Aides), Oklahoma State Courts Network. The live statute. Establishes the Department's duty to issue certificates of training and competency, the minimum ten hours of Alzheimer's training, the registry duty, the $15 fee ceiling, the CNA title protection and its civil monetary penalty, the deeming of a certified nurse aide as qualified for home health aide work, and the registry's required contents and timelines.\", \"url\": \"https://www.oscn.net/applications/oscn/DeliverDocument.asp?CiteID=98638\"}, {\"label\": \"Oklahoma State Department of Health — 'Excerpt from Nursing Home Care Act, 63 O.S. § 1-1950.1 – 63 O.S. § 1-1951, Applicable to Nurse Aide Training and Certification' (the Department's own PDF, headed 'Unofficial Version, As Amended November 1, 2017'). Establishes the definitions of nurse aide, employer and home health or home care agency; the pre-offer criminal history background check duty under the Long-term Care Security Act; the $15 Bureau fee, the temporary-employment allowance and the 72-hour notice; and the list of convictions that bar hiring.\", \"url\": \"https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/protective-health/hrds/nurse-aide-registry/63-os-1-1950.1-63-1-1951-nurse-aide-certification-11-1-2017.pdf\"}, {\"label\": \"Oklahoma State Department of Health — Nurse Aide Renewal Application, ODH Form 717, revised 12/2023 (the packet also contains ODH Form 301, the Affidavit of Lawful Presence). Establishes the renewal fee grid in the Department's own checkboxes ('LTC – No Fee', 'HHA - $10 Fee', 'ICF/IIDCA - $10 Fee', 'RCA - $10 Fee', 'ADCA - $10 Fee', 'Feeding Assistant (FA) - $10 Fee', 'CMA - $10'); the CMA continuing-education attachment of 'eight (8) hours for every twelve months of certification, excluding the first year'; the employment-verification section requiring 'proof of 8 hours paid work in nursing or nursing related services during the 24-month certification time frame' by administrative signature, paystub or Form W-2; 'All Fees submitted are NON-Refundable'; and the citizenship or approved-alien affidavit with its instruction that a health department certificate 'is not authorization for employment in the United States.'\", \"url\": \"https://oklahoma.gov/content/dam/ok/en/health/health2/aem-documents/protective-health/long-term-care-services/forms/current/renewal/ODH%20717.301%20Renewal%20App%2006.24.pdf\"}, {\"label\": \"Oklahoma Department of Career and Technology Education — CareerTech Testing Center, Health & Professional Certifications: Nurse Aide (page last modified January 7, 2026). Establishes the state agency that gives the written examination and its five exam codes ('Long Term Care - 7C', 'Home Health Care - 5A', 'ICF/IID Care - 2A (formerly Developmentally Disabled Care)', 'Adult Day Care - 3A', 'Residential Care - 4A'); the prerequisite that a 'Candidate must complete an approved training program'; the fee statement 'Candidate must pay testing fees to the test site upon registration'; the required documentation (original Training Verification Form or NAR approval letter, US government photo ID, proof of SSN or an SSN Attestation Form); and the candidate resources — Certified Nurse Aide Study Guide, HCP Test Sites, Approved Training Programs and Practice Scenarios.\", \"url\": \"https://oklahoma.gov/careertech/testing-center/health-professional-certifications/nurse-aide.html\"}, {\"label\": \"Oklahoma State Department of Health — Verify A Nurse Aide (the public registry lookup). The live search form whose own inputs establish the three search fields listed under Verify a license on this page (last name, first name, certification number) and the JavaScript requirement.\", \"url\": \"https://www.phin.state.ok.us/NARSWBSearch/Views/LandingView.aspx?id=5006\"}, {\"label\": \"Oklahoma State Department of Health — Nurse Aide and Nontechnical Services Worker Abuse Registry, the second lookup the Department links from its Nurse Aide Registry page, covering substantiated findings against nurse aides and nontechnical services workers.\", \"url\": \"https://www.phin.state.ok.us/nar/\"}]",
   "page_url": "https://licensingatlas.com/cna/ok-cna/"
  },
  {
   "page_id": "or-cna",
   "state": "Oregon",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Oregon State Board of Nursing (OSBN). Unusually among the states on this site, the nurse aide credential in Oregon comes from the board of nursing itself rather than from a health department or a registry contractor: 'The Oregon State Board of Nursing shall establish standards for certifying and may certify as a nursing assistant any person who' meets the statutory conditions (ORS 678.442(1)), and 'In accordance with federal regulations, the Board maintains a CNA Registry' (OAR 851-062-0012). The Board also approves the training programs (ORS 678.444) and sets the curriculum.",
   "board_url": "https://www.oregon.gov/osbn/Pages/index.aspx",
   "application_url": "https://www.oregon.gov/osbn/Pages/Licensing_How-tos.aspx",
   "renewal_cycle": "Every two years, and Oregon's renewal is a paperwork exercise rather than a work test — there is no hours-worked requirement here at all, which sets it apart from most of the states on this site. 'An NA certificate is valid for two years from the date it is issued. Certificate holders must apply for renewal by 11:59 p.m. on the date of their license expiration to be considered timely' (OAR 851-062-0070(1)). What the renewal application must contain: the Board's renewal form; payment of the applicable fees ($60 plus the $8 Workforce Data Analysis Fund surcharge, raised from $4 effective August 22, 2026); and 'Every 48 months or every other renewal cycle, the applicant must attest to completion of two hours of cultural competency continuing education.' The criminal background check is still part of renewing - it moved, it did not disappear. Until August 31, 2026 the renewal rule itself required 'Completion of state records criminal background check as described in OAR 851-001-0115'; effective September 1, 2026 the Board removed that clause from OAR 851-062-0070 as redundant, and the requirement now rests on OAR 851-001-0115, which applies 'When applying for a license or certification to practice, including renewal'. Timing: 'A renewal application may be submitted no more than 90 days before the expiration of the certificate', and 'Once a certificate has been expired for more than 90 days, an individual must apply for reinstatement as described in OAR 851-062-0071.' Incomplete renewal applications expire 12 months after submission. An extra step the rule does not mention but the Board's own guide does: before the renewal application can be completed you must finish an Oregon Health Authority survey inside the licensing system, and 'It can take up to 90 minutes for the OHA computer to sync with our computer to show the survey as complete.' Renewals are processed automatically once paid — 'your expiration date will change as soon as you complete the payment' — and the updated certificate can be looked up, printed or emailed from the Board's verification portal. The statute behind the cycle: 'The board shall establish by rule a procedure for the biennial renewal of nursing assistant certificates. The certificate renewal procedure must be substantially like the procedure established for the licensing of nurses under ORS 678.101' (ORS 678.442(3)).",
   "ce_hours": "Two hours of cultural competency continuing education every 48 months — that is the CNA requirement, and the Board states it twice. In rule: 'Every 48 months or every other renewal cycle, the applicant must attest to completion of two hours of cultural competency continuing education' (OAR 851-062-0070(2)(c), renumbered from (2)(d) on September 1, 2026). In the Board's CNA FAQ, answering 'What continuing education (CE) is required for the renewal of the CNA certificate?': 'CNAs must obtain two hours of cultural competency continuing education every 48 months after initial certification.' The Board's renewal guide adds where to get it: 'Two hours of Cultural Competency Continuing Education can be completed through an organization of your choice. It can be free or completed through your employer. Oregon Health Authority maintains a list of suggested courses.' The same two hours are required outright — not on the 48-month cycle — when reinstating a certificate expired more than 90 days but no more than two years (OAR 851-062-0071(1)(d)). What is not required, stated affirmatively by the Board: 'Are CNAs required to have Basic Life Support (BLS) training and/or first aid training to renew the certificate? A: No. This is not a requirement for renewal.' A second continuing-education item appears in the Board's application guides but not in the CNA rule, and both are recorded: the Board's All License Type Renewal Application Guide lists 'One hour of Pain Management Continuing Education through Oregon Pain Management Commission's Module, if you have not completed in the last 36 months', and its CNA-by-Endorsement directions make that same hour an eligibility condition — 'Applicants must: Complete 1 hour pain management training from OR Pain Management Commission within the last 36 months and...'. Neither OAR 851-062-0070 nor the Board's CNA FAQ names pain management among the CNA's renewal requirements. This page reports both and resolves neither; an applicant should plan on the module. The certified medication aide is different and should not be conflated: a CMA must 'Attest to completion of eight hours of continuing education within the past two years related to medication aide authorized duties' (OAR 851-062-0110(2)(c) (renumbered from (2)(d) on September 1, 2026)).",
   "exam": "Two parts — a knowledge (written) test and a manual skills test — both required, taken through the Board's testing system after the application is filed. The Board's own sequence is: apply and pay through the OSBN system, then 'Sign in to TMU and select date', then 'Step 6: Pass both tests.' What the rule controls (OAR 851-062-0055): 'Reference materials, including dictionaries, may not be used during testing'; 'Language translation aids must not be used for exam purposes. This includes translators, documentation or electronic devices that translate one language to another'; and a walk-out counts against you — 'If a candidate decides not to complete the examination after receiving the knowledge test booklet or the skill test instructions, the attempt will be scored as a failure.' Results are 'mailed or emailed to the applicant at the applicant's address of record and will not be released by telephone', and 'Failure to take the examination or to reschedule the examination in advance will result in re-examination fees unless the absence has been excused by the testing service.' Accommodations: an applicant with a disability must file the Board's accommodation request form and have primary source documentation sent directly to the Board by the diagnosing provider or learning specialist, naming the disability and diagnosis, the diagnostic study used, the accommodation needed and the provider's original signature and title; someone who has been ill or under a temporary activity restriction 'must arrange for the healthcare provider to send the Board a medical release for full return to normal activity before taking the manual skills portion of the exam.' Retakes: you re-apply and pay through your OSBN account, not through the testing system directly — 'Costs: Retest of Manual/Skills $45, Retest of Written/Knowledge Test $25.' There is a wait built into the process: 'It can take up to 5 business days for TMU to upload test results to OSBN. Do not contact OSBN about a failed test results until after 5 business days.' A reinstatement candidate has one shot before retraining: someone reinstating a certificate expired more than two years must pass the Board-approved exam, and 'Applicants who do not pass the examination are required to complete a training program prior to a retake' (OAR 851-062-0071(3)). Not published by the Board, and searched for across OAR 851-062, the Board's CNA exam, endorsement and retake directions, the Board's CNA FAQ and the state's testing-system pages: the number of questions, the time allowed, and the passing score for either part. Those figures are left empty rather than imported from another state's booklet.",
   "fees": "Oregon publishes a complete fee schedule in rule, at OAR 851-002-0040 (Nursing Assistant Schedule of Fees): Certification by Examination (inclusive of examination fees) — $106; Certification by Endorsement — $60; Re-Examination, Manual Skills — $45; Re-Examination, Written — $25; Oral Administration of Written Examination (non-ADA) — $35; Written Verification of Certification — $10; Renewal — $60; Reinstatement — $60; Surcharge to Support the Workforce Data Analysis Fund at Renewal - $8 (raised from $4 effective August 22, 2026, passing through the Oregon Health Authority's increase in the health care workforce reporting fee from $2 to $4 per license year); Certification for RN or LPN — $60; Temporary Certificate for Active Armed Forces Military Spouse or Domestic Partner — $50; Delinquent Fee — $5. Two more from the miscellaneous schedule (OAR 851-002-0055): Fingerprinting - $58; Predetermination - $75. This fee rises on October 1, 2026. The Board filed a temporary rule on August 21, 2026 setting 'Fingerprinting - $61' effective October 1, 2026 and running through March 29, 2027, passing through a $3.00 increase in the FBI's charge for criminal history record checks; the Board's own explanation is that its next meeting, October 15, 2026, falls after the effective date, so the increase was made temporarily first. Until September 30, 2026 the fee is $58. The medication aide schedule is separate and much cheaper (OAR 851-002-0050): Certification by Examination $60, Certification for RN or LPN $20, Renewal $15, Reinstatement $30, Re-Examination $25. Two general rules sit on top: 'The fees paid to the Oregon State Board of Nursing are refundable at Board discretion. The licensing/certification fee pays for processing the application, and the license/certificate is valid until the expiration date', and a military exemption — 'As required by ORS 408.450, if allowed by Department of Defense policy, no fees will be assessed while any person holding a license or certificate with the board is on active duty with the Uniformed Services of the United States', with written notice to the Board within 60 days of honorable discharge to restore the former status without fee or penalty. ⚠️ an official Oregon page says something different, and both are the state's. The Oregon Secretary of State's Business Xpress License Directory entry for 'Nursing Assistants, Certified' (last updated 05/12/2026) shows a fee table reading 'License Fee $0.00' with no description and no exemptions. That cannot be reconciled with the rule schedule above, which is the Board's own and which the Board's application directions use ('Retest of Manual/Skills $45, Retest of Written/Knowledge Test $25'). This page follows the rule and reports the directory entry as a conflict rather than silently discarding it. Not set by the state: training tuition. Programs must publish 'Fees, tuition, and other program costs (books, clothing, etc.) itemized separately' in a student enrolment agreement, along with a cancellation and refund policy that must refund tuition and fees in full if the program closes mid-course, and must refund all but a cancellation fee capped at ten percent if the student cancels in writing three days before classes or before online access begins (OAR 851-061-0030(3)(i)).",
   "legal_basis": "[{\"citation\": \"Or. Rev. Stat. 678.440 to 678.448 (Nursing Assistants), within ORS chapter 678\", \"what_it_governs\": \"The Oregon nursing assistant scheme in statute: the definitions of 'nursing assistant' and 'medication aide'; the Board's duty to prepare curricula and standards; the civil penalties the Department of Human Services and the Oregon Health Authority may impose on a facility that employs an untrained nursing assistant for more than eight weeks (678.440); certification standards and the three qualifying routes, the grounds for discipline, the requirement of biennial renewal by rule 'substantially like the procedure established for the licensing of nurses under ORS 678.101', and the Governor-declared-emergency limited certificate (678.442); Board approval and survey of training programs and revocation of approval by contested case (678.444); administration of noninjectable medication by a nursing assistant (678.445); and the protected titles for medication aides (678.447) and for nursing assistants, including the student title and the 120-day allowance for a program graduate newly hired by a nursing facility (678.448).\", \"url\": \"https://www.oregonlegislature.gov/bills_laws/ors/ors678.html\"}, {\"citation\": \"Or. Admin. R. ch. 851, div. 62 (Standards for Certification of the Nursing Assistant and Medication Aide)\", \"what_it_governs\": \"Name, contact and employer of record and the 30-day employer-change duty; the contents of the CNA Registry; the rule that certification plus registry listing is required before performing CNA duties, and that completing a program and exam alone is not enough; initial certification eligibility and its four qualifying routes; the military spouse temporary certificate; examination accommodations, controls and result-release rules; the Governor-declared-emergency limited certificate; two-year renewal with the state records background check and the 48-month cultural competency attestation; reinstatement at the 90-day and two-year thresholds; disciplinary reinstatement; and the parallel CMA provisions. Most sections in this division were amended by BN 9-2025 effective 07/01/2025, again by BN 29-2025 effective 11/20/2025, and again by BN 5-2026 effective 09/01/2026 (nine division-62 rules amended).\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3941\"}, {\"citation\": \"Or. Admin. R. ch. 851, div. 61 (Standards for Education Programs for Nursing Assistants and Medication Aides)\", \"what_it_governs\": \"Approval of new programs and what the application must contain, including the student enrolment agreement, itemised tuition and the mandatory cancellation and refund policy; periodic evaluation and survey visits at least every two years; inactive status and closure; denial and withdrawal of approval, including the federal grounds tied to a nursing facility's survey and enforcement history and the published examination pass-rate thresholds; and, at 851-061-0090, the Board-approved curricula and the 105-hour nursing assistant program with its 37 classroom, 28 laboratory and 40 clinical hours, the on-line variant, and the 80-hour medication aide program.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3940\"}, {\"citation\": \"Or. Admin. R. ch. 851, div. 63 (Standards and Authorized Duties for the Certified Nursing Assistant and Certified Medication Aide)\", \"what_it_governs\": \"The four standards every CNA works under, including 'A CNA may not work independently'; the full list of authorized duties across collaboration, communication, client-centered care, infection prevention, safety and emergency procedures, activities of daily living and technical skills; the additional authorized duties an employer's RN may teach and validate, and the three that need an outside credential first (phlebotomy, child safety seat checks, telemetry monitoring); the medication aide's duties; and conduct unbecoming a nursing assistant. This is the division the July 2025 consolidation rewrote.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3942\"}, {\"citation\": \"Or. Admin. R. ch. 851, div. 2 (Agency Fees) — 851-002-0000, 851-002-0040, 851-002-0050 and 851-002-0055\", \"what_it_governs\": \"The Board's published fee schedules: the general refund and active-duty provisions; the Nursing Assistant schedule ($106 by examination inclusive of exam fees, $60 endorsement, $45 and $25 re-examinations, $35 non-ADA oral administration, $10 written verification, $60 renewal, $60 reinstatement, the $4 workforce data surcharge, $60 for an RN or LPN, $50 military spouse temporary certificate, $5 delinquent fee); the separate Certified Medication Aide schedule; and the miscellaneous fees for fingerprinting ($58) and predetermination ($75).\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3922\"}]",
   "exam_vendor": "D&S Diversified Technologies / Headmaster, delivering the Board-approved competency examination through its TestMaster Universe (TMU) system at or.tmutest.com. The Board sends candidates there in its own application directions — 'Step 5: Sign in to TMU and select date. Visit https://or.tmutest.com/' — routes testing accommodations through the same system ('You will need to submit an application for testing accommodations with your TMU account'), and builds the retake around it: after paying the Board for a retake, 'The retest payment to OSBN can take up to 4 hours to show in up in the TMU system', then 'Check your email for a TMU email saying you have been released to schedule.' The system's own Oregon application list names the contractor — the test review form instructs candidates to call 'D&SDT-HEADMASTER staff for a test results consultation' — and shows the roles the state's testing network is built from: RN Test Observer / Test Administration Services Entity, Knowledge Test Proctor, Actor, and approved Test Sites. The rule keeps the exam at ARM'S length from the candidate's school only for the medication aide examination, which 'shall be administered and evaluated only by the Board or by a Board-approved entity' (OAR 851-062-0100). Vendors are named here because Oregon names them; nothing on this page rates or recommends any provider.",
   "training_hours": "At least 105 hours, split 37 classroom / 28 laboratory / 40 clinical — the highest floor in this tranche, and it is set by rule rather than by agency prose. OAR 851-061-0090(2): 'A nursing assistant education program must consist of at least 105 hours divided into: (a) At least 37 hours of classroom instruction, which may be provided via a live virtual platform; (b) At least 28 hours of supervised laboratory instruction with return student demonstrations of learned skills to determine comprehension and competency, in addition to facility orientation, preceding the students' care of clients; and (c) At least 40 hours of supervised clinical experience during which the student has the opportunity to perform the skills taught in the Board-approved nursing assistant curriculum.' An on-line program must hit the same totals: 851-061-0090(3) repeats all three figures, converting only the didactic portion to 'the equivalent of 37 hours... according to the nationally recognized standard of content to credit ratio', and requiring the 28 laboratory hours to follow 'no later than two weeks after the successful completion of the on-line portion.' The curriculum itself is a named, dated document: 'Nursing assistant and medication aide education programs must use Board-approved curricula. The Board-approved curriculum for nursing assistant education is found in Curriculum Content for Assistant Education Programs (approved 02/20/2025; effective 07/01/2025)' — and the Board's own Q&A is explicit that the July 2025 consolidation did not change what is taught: 'No, there will not be any changes to the nursing assistant (NA) curriculum content that has been in place since August 1, 2023. NA curriculum task force and rule advisory committee members reviewed the NA curriculum, and no changes or additions were recommended.' Two things to keep straight. First, 105 hours is the nursing assistant figure; the medication aide program is a separate 80 hours (45 didactic, 11 laboratory, 24 hours of 1:1 clinical). Second, Oregon is well above the 75-hour federal floor, so a page quoting 75 hours for Oregon is quoting the federal minimum rather than Oregon's rule.",
   "lapse_rule": "Oregon's ladder has three rungs, set by how long the certificate has been expired, and there is no work-hours element anywhere in it. Ninety days or less: still a renewal. 'A renewal application may be submitted no more than 90 days before the expiration of the certificate', and only 'Once a certificate has been expired for more than 90 days' does the individual move to reinstatement (OAR 851-062-0070(3)-(4)); a $5 delinquent fee sits in the fee schedule. More than 90 days but no more than two years: reinstatement without retesting. The application needs the Board's reinstatement form, the fee ($60), 'Completion of a national fingerprint-based background check as described in OAR 851-001-0115' and 'Completion of two hours of cultural competency continuing education' — note that the CE is required outright here rather than on the 48-month cycle (OAR 851-062-0071(1)). More than two years: retesting. 'An individual whose Oregon CNA certification has been expired for over two years must apply for reinstatement by submitting a completed application and passing the Board-approved competency examination' (as amended September 1, 2026; the rule previously said such an individual 'can apply' and now says 'must apply', and the second chance is conditional: 'Applicants who do not pass the examination are required to complete a training program prior to a retake' (851-062-0071(2)-(3)). Revoked or surrendered is a different door entirely: 'An individual whose NA certification has been revoked or voluntarily surrendered is not eligible for reinstatement under OAR 851-062-0071 but may apply for disciplinary reinstatement', which requires the Board's disciplinary reinstatement form, the fee, 'Proof of completion of an NA training program following revocation or surrender', passage of the Board-approved competency exam after the application is submitted, and a national fingerprint-based criminal background check (OAR 851-062-0075). What puts a certificate at risk in the first place (ORS 678.442(2)): conviction of a crime bearing a demonstrable relationship to the duties of a nursing assistant; 'Any willful fraud or misrepresentation in applying for or procuring a certificate or renewal'; impairment as defined in ORS 676.303; violation of ORS 678.010 to 678.448 or the Board's rules; a physical condition that makes the holder unable to perform the duties safely; and 'Conduct unbecoming a nursing assistant in the performance of duties' — a phrase the Board fills out in OAR 851-063-0090 with items including discriminating against a client, abusing or neglecting a client, failing to report actual or suspected abuse either through workplace channels or to the appropriate state agency, sexual misconduct with a client in any setting or in the workplace, and failing to maintain professional boundaries. The Board's registry separately carries 'Findings of resident abuse, neglect or misappropriation of resident property, made by the Department of Human Services against a CNA' — those findings are made by ODHS, not by the Board. Also worth knowing: an expired certificate is not a technicality. Working on an expired temporary or limited certificate 'is considered practicing without a valid certificate and is subject to Board action.'",
   "reciprocity": "Oregon calls it endorsement, prices it at $60, and runs it through the same rule as an initial application. The rule route: an out-of-state certification substitutes for the examination rather than for everything — 'For applicants with NA certification in another state or U.S. territory at the time of application, the active certification may be considered proof of completion of the Board-approved competency examination' (OAR 851-062-0050(2)) — while the training element is satisfied by 'Proof of completion, including date of completion of a nursing assistant training program approved by the Board or, for non-Oregon programs, by the appropriate agency in that state or U.S. territory.' The fingerprint check, the fees and the application form still apply. The Board's own eligibility list for the endorsement application is broader than 'another state's CNA' and includes one condition the rule does not state: 'Applicants must: Complete 1 hour pain management training from OR Pain Management Commission within the last 36 months and hold an active CNA in another state or submit a DD214 transcript showing military training or hold an active RN/LPN in good standing or be an active Student Nurse and provide requirements listed in NPA 851-062-0050.' You must also send the Board your training certificate — uploaded with the application or emailed to the Board's CNA certificates address — and 'If you are unable to locate your program, you may choose \"Other\" to enter the required information.' Two time-limited alternatives for people who cannot wait for a full endorsement: the military spouse temporary certificate (OAR 851-062-0054, $50, non-renewable, two-year outside limit) and the Governor-declared-emergency limited certificate (OAR 851-062-0061, application fee waived, non-renewable), both of which require primary source verification of an active unencumbered certification elsewhere and both of which the rules say must be converted to permanent Oregon certification by endorsement to continue working. Going the other way: the Board charges $10 for a 'Written Verification of Certification.' Not published, and searched for across OAR 851-062 in full, the Board's endorsement directions, its CNA FAQ and the Secretary of State's license directory entry: any processing time for an endorsement decision beyond the directory's general '1 Week' processing note, which is itself qualified as 'dependent upon receipt of background check information and all other relevant documents.'",
   "last_verified": "2026-09-02",
   "source_urls": "[{\"label\": \"Oregon State Board of Nursing — CNA 1 & 2 Consolidation. Establishes the headline change in the Board's own words: 'One Level of CNA in Oregon: As of July 1, 2025, after almost three years of public process work and input from employers, CNAs, and educators, the CNA1 and 2 designations have been retired and there is one level of CNA in Oregon', and links the consolidation Q&A, timeline and fact sheet, the three governing rule divisions, the Board's lunch-and-learn sessions and the rule advisory committee minutes.\", \"url\": \"https://www.oregon.gov/osbn/pages/cna-consolidation.aspx\"}, {\"label\": \"Oregon State Board of Nursing — CNA Consolidation: What You Need to Know (Q&A dated 3-1-25). Establishes that the consolidation did not change the curriculum ('there will not be any changes to the nursing assistant (NA) curriculum content that has been in place since August 1, 2023'); that employers may teach additional authorized duties in groups but 'RNs must teach and perform competency validation'; that additional duties do not travel to a new employer ('If it is a new employer, you will need to complete training and competency evaluation again'); that the Board publishes no competency validation form and does not survey employment sites; and that 'Community based care settings are no longer included in Div. 63 since they are governed by the Oregon Department of Human Services, Residential Care and Adult Foster Home Divisions.'\", \"url\": \"https://www.oregon.gov/osbn/Documents/Resource_CNA-Consolidation-QandA-3-1-25.pdf\"}, {\"label\": \"Oregon State Board of Nursing — Certified Nursing Assistant (CNA) Exam Application Steps (dated as of 12-31-25). Establishes the application sequence through the Board's own system; the disclosure-question rules; the training-certificate upload or email; the Fieldprint fingerprint procedure and its FPORBoardNursingDAS code with 'Do not submit fingerprints before application'; the routing of testing accommodations through the TMU account; 'Step 5: Sign in to TMU and select date. Visit https://or.tmutest.com/'; the processing waits ('Test results can take up to 7 business days'; 'Fingerprint results can take up to 4 weeks to be received from the FBI'); and the retest costs 'Retest of Manual/Skills $45, Retest of Written/Knowledge Test $25.'\", \"url\": \"https://www.oregon.gov/osbn/Documents/Resource_CNAExamAppDirections.pdf\"}, {\"label\": \"Oregon State Board of Nursing — Certified Nursing Assistant (CNA) by Endorsement Application Steps (dated as of 12-31-25). Establishes the Board's own endorsement eligibility list: 'Complete 1 hour pain management training from OR Pain Management Commission within the last 36 months and hold an active CNA in another state or submit a DD214 transcript showing military training or hold an active RN/LPN in good standing or be an active Student Nurse and provide requirements listed in NPA 851-062-0050', plus the training-certificate submission and the Fieldprint fingerprint step.\", \"url\": \"https://www.oregon.gov/osbn/Documents/Resource_CNAEndorseAppDirections.pdf\"}, {\"label\": \"Oregon State Board of Nursing — CNA Exam Retake Directions (dated as of 12-31-25). Establishes the retake mechanics: 'It can take up to 5 business days for TMU to upload test results to OSBN. Do not contact OSBN about a failed test results until after 5 business days'; select and complete the 'CNA Exam – Retake' application in the OSBN account; 'Wait 4 hours. Check your email for a TMU email saying you have been released to schedule.'\", \"url\": \"https://www.oregon.gov/osbn/Documents/Resource_CNAExamRetakeDirections.pdf\"}, {\"label\": \"Oregon State Board of Nursing — All License Type Renewal Application Guide (dated as of 12-31-25). Establishes the Oregon Health Authority survey step that precedes the renewal application and its 90-minute sync delay; the continuing-education checklist including 'One hour of Pain Management Continuing Education through Oregon Pain Management Commission's Module, if you have not completed in the last 36 months' and 'Two hours of Cultural Competency Continuing Education... This CE must be completed every 48 months'; and that 'Renewals are processed automatically, so your expiration date will change as soon as you complete the payment.'\", \"url\": \"https://www.oregon.gov/osbn/Documents/Resource_RenewalAppDirections.pdf\"}, {\"label\": \"Oregon State Board of Nursing — CNA Frequently Asked Questions. Establishes 'The Board does not set an age requirement for nursing assistant certification or medication aid certification'; 'CNAs must obtain two hours of cultural competency continuing education every 48 months after initial certification'; 'Are CNAs required to have Basic Life Support (BLS) training and/or first aid training to renew the certificate? A: No'; the narrow medication list a CNA may administer under OAR 851-063; 'Straight catheterization is not a CNA authorized duty'; and that Oregon's Nurse Practice Act 'does not regulate staffing, work breaks, labor agreements, or HR matters.'\", \"url\": \"https://www.oregon.gov/osbn/pages/faqs_cna.aspx\"}, {\"label\": \"Oregon State Board of Nursing — Nurse Practice Act & Rules. The Board's own index to ORS chapter 678 and to every division of OAR chapter 851, and the source of the division links used in the legal basis (division 61 education programs, division 62 certification standards, division 63 authorized duties, division 2 agency fees).\", \"url\": \"https://www.oregon.gov/osbn/Pages/laws-rules.aspx\"}, {\"label\": \"Oregon State Board of Nursing — How to Apply for a License. The Board's application hub, linking the CNA exam, endorsement and retake directions and the renewal guide.\", \"url\": \"https://www.oregon.gov/osbn/Pages/Licensing_How-tos.aspx\"}, {\"label\": \"Or. Admin. R. ch. 851 div. 62 (Standards for Certification of the Nursing Assistant and Medication Aide), Oregon Secretary of State Administrative Rules. Establishes the certification-plus-registry rule, the four initial-eligibility routes and the out-of-state-certification substitution, the 12-month expiry of incomplete applications, the examination controls and accommodation rules, the two-year certificate and its renewal contents including the 48-month cultural competency attestation and the 90-day submission window, the reinstatement thresholds at 90 days and two years, disciplinary reinstatement, the military spouse temporary certificate and the emergency limited certificate, and the CNA Registry contents.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3941\"}, {\"label\": \"Or. Admin. R. ch. 851 div. 61 (Standards for Education Programs for Nursing Assistants and Medication Aides), Oregon Secretary of State Administrative Rules. Establishes the 105-hour nursing assistant program and its 37/28/40 split, the identical totals for on-line programs, the named and dated Board-approved curriculum documents, the clinical-setting and RN-on-duty requirements, the student enrolment agreement and refund rules, the two-year re-approval cycle, and the examination pass-rate thresholds that can cost a program its approval.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3940\"}, {\"label\": \"Or. Admin. R. ch. 851 div. 63 (Standards and Authorized Duties for the Certified Nursing Assistant and Certified Medication Aide), Oregon Secretary of State Administrative Rules. Establishes 'A CNA may not work independently', the base list of authorized duties, the additional authorized duties an employer's RN may teach and validate and the three requiring an outside credential, and conduct unbecoming a nursing assistant.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3942\"}, {\"label\": \"Or. Admin. R. ch. 851 div. 2 (Agency Fees), Oregon Secretary of State Administrative Rules. Establishes the Nursing Assistant, Certified Medication Aide and miscellaneous fee schedules quoted in fees, and the general refund and active-duty provisions.\", \"url\": \"https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=3922\"}, {\"label\": \"Or. Rev. Stat. ch. 678 (Nurses; Nursing Assistants; Nursing Home Administrators), Oregon Legislature. Establishes ORS 678.440 through 678.448 as quoted throughout this page, including the eight-week facility limit, the three certification routes, the biennial renewal directive, the emergency limited certificate, and the title protections at 678.447 and 678.448 with the 120-day nursing-facility allowance.\", \"url\": \"https://www.oregonlegislature.gov/bills_laws/ors/ors678.html\"}, {\"label\": \"Oregon Secretary of State — Business Xpress License Directory, 'Nursing Assistants, Certified' (last updated 05/12/2026). An official state directory entry describing the credential ('Oregon CNAs are trained in Board-approved programs and must qualify for and pass a Board-approved examination to become certified'), its two-year duration, a '1 Week' processing time 'dependent upon receipt of background check information and all other relevant documents', and no bonding or insurance requirement. ⚠ It also states 'License Fee $0.00' and 'Continuing Education Requirements: None', both of which contradict the Board's own rules — cited here so the conflict is on the record rather than hidden.\", \"url\": \"https://apps.oregon.gov/SOS/LicenseDirectory/LicenseDetail/801\"}, {\"label\": \"Oregon State Board of Nursing License Verification Portal. The Board's public lookup, whose own form options establish the three search modes and the license-type list shown under Verify a license on this page, the security-verification step, the August 2010 limit on disciplinary documents, and the links to the civil penalties list, the CNA Abuse Registry and the OBRA Federal CNA Registry.\", \"url\": \"https://osbn.boardsofnursing.org/licenselookup\"}, {\"label\": \"Oregon Nurse Aide TMU — the Board's testing system. Establishes the roles the state's testing network is built from (RN Test Observer / Test Administration Services Entity, Knowledge Test Proctor, Actor, approved Test Sites, program director, primary instructor, clinical teaching associate), the $25 test review request and its reference to D&SDT-HEADMASTER, and the ADA accommodation and no-show exception applications.\", \"url\": \"https://or.tmutest.com/apply\"}]",
   "page_url": "https://licensingatlas.com/cna/or-cna/"
  },
  {
   "page_id": "pa-cna",
   "state": "Pennsylvania",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Pennsylvania Department of Health, Division of Nursing Care Facilities — Nurse Aide Registry (the Department states it 'administers the Commonwealth contract to provide nurse aide registry services' and that it 'has oversight responsibility of the Registry and contracts with Credentia to do day-to-day management'). Nurse aide training programs are approved by a different agency: the Pennsylvania Department of Education, Bureau of Career and Technical Education.",
   "board_url": "https://www.pa.gov/agencies/health/business-registration-and-regulation/nurse-aide",
   "application_url": "https://www.pa.gov/services/health/apply-to-become-a-nurse-aide",
   "renewal_cycle": "Every 24 months, and the renewal test is work, not education. 'To be eligible for continued enrollment you are required to work for pay as a nurse aide in a nursing environment such as a nursing home, hospital or home health setting for at least eight hours during the previous 24 months of enrollment. Self-employed or private duty experience is not recognized as work experience for continued enrollment' (Department of Health). The Pennsylvania NNAAP Candidate Handbook states the same requirement as one shift: 'you are required to work as a nurse aide at least one documented day (i.e. 8 consecutive hours) for pay in an approved facility (such as a nursing home, personal care home, hospital, home health setting or intermediate care facility) during the previous twenty-four (24) months.' Notice: 'The Department of Health will mail a notification of continued enrollment on the nurse aide registry to the home address of the nurse aide as listed on the registry approximately 90 days prior to expiration' — which is why the state repeats that 'The Registry must be kept informed of your current address.' After renewing: 'you will receive an electronic Registry Card by email and Credentia will also mail a new Registry Card (also known as a Notice of Enrollment), which will be valid for the next twenty-four (24) months.' A 2026 expansion of what counts, in the Department of Health's own words: 'The Pennsylvania Department of Health (DOH) recently updated the DOH Approved Employer List to include Home Care Agencies/Registries for Nurse Aide Registry Renewal. If individuals have been denied a renewal based on using a Home Care Agency/Registry, please consider submitting a new application for renewal if the employer has been added to the list.' The Department does not date that update, and the Approved Employer List itself is published on the contractor's site rather than the Department's.",
   "ce_hours": "None for registry renewal. The state-linked Pennsylvania NNAAP Candidate Handbook answers it directly: 'How many training hours must I have annually to renew my registry? There are no \"training requirements\" to renew your registry. Rather, the nursing homes administration is required to provide nurse aides a minimum of twelve (12) hours of in-service education each year based on the results of yearly performance evaluations.' The Handbook is explicit that the in-service obligation runs to the employer and not to the aide's registry status: '42 CFR 483.75(e)(8) requires that facilities provide at least twelve (12) hours of training to their nurse aides based on needs identified in yearly performance reviews... While these are requirements associated with State and Federal Long-Term Care regulations, they are not requirements inherent to the Nurse Aide Registry and have no impact on registry renewal.' ⚠ A staleness finding the reader should know: the Handbook attributes a twelve-topic annual in-service list to 'PA State Code 201.20'. The live text of 28 Pa. Code § 201.20 (Staff development), as amended December 23, 2022 and effective July 1, 2023, does not contain that list. It now requires 'annual in-service training on the topics outlined in 42 CFR 483.95 (relating to training requirements) in addition to the following topics: (1) Accident prevention. (2) Restorative nursing techniques. (3) Emergency preparedness in accordance with 42 CFR 483.73(d). (4) Fire prevention and safety in accordance with 42 CFR 483.90. (5) Resident rights, including nondiscrimination and cultural competency. (6) Training needs identified through a facility assessment.' The Handbook's list is the pre-2023 version of the rule. Either way it is a facility duty, not a condition of the aide's enrolment.",
   "exam": "Two parts, both required: a skills evaluation and a written (or oral) examination. 'There are two parts to this examination process-a skills examination and a written examination. All nurse aide applicants must pass both examinations before being listed on the Nurse Aide Registry' (Department of Health). Where: 'You may take Written (or English Oral) examination either online or at a test center. Skills Evaluations are only offered at a test center.' Written: 'The Written Examination consists of seventy (70) multiple-choice questions written in English', with up to two hours allowed. Skills: 'you will be asked to perform five (5) randomly selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator', and 'For the Skills Test, the allowable testing period is 30 minutes.' Oral — and a conflict on the same official page, recorded both ways and not resolved silently: the Department of Health's Examination Overview section states that the oral form 'consists of sixty (60) multiple-choice questions plus ten (10) reading comprehension/word recognition questions', while its own 'Oral Test in English' section further down the same page states that 'The oral test in English consists of 50 multiple choice questions that are presented orally on cassette tape plus ten reading comprehension questions in which the nurse aide must identify common job-related words.' Both sentences are the Commonwealth's; this page reports both and picks neither. (The same section's reference to a cassette tape sits oddly against the same page's statement that the written or oral exam may be taken online — noted, not reconciled.) An oral form must be chosen at scheduling: 'If you want to take the English Oral Examination, you must select it when you schedule your exam.' Scheduling: through a Credentia Platform account, and 'You may not be scheduled and tested until you have completed your training.' Results: 'Score reports are generally available within a few hours after a testing event is completed for the day', delivered online — 'Examinations results will not be given over the telephone nor can they be sent by Credentia to your employer.'",
   "fees": "Pennsylvania publishes no state application or enrolment fee for the nurse aide registry — the Department of Health's fee section says only 'Refer to current Nurse Aide Handbook, consult with a Credentia Customer Service Representative or your employer if you need help to determine the proper fees.' The examination fees are in that Handbook: Written & Skills Exam (both exams) $135; Oral & Skills Exam (both exams) $135; Written Exam, re-test only, $50; Oral Exam, re-test only, $50; Skills Exam, re-test only, $85. 'You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test' and 'Fees are not refundable.' Who pays: 'Under Federal and Pennsylvania laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test' (Handbook), which the Department of Health restates as 'According to the OBRA Rules and Regulations, if you are currently employed in a nursing facility in Pennsylvania, your employer must pay this fee. If you are not currently employed in a nursing facility in Pennsylvania, you must pay this fee.' Payment is 'in the form of a credit card, debit card, ACH (electronic check), or electronic voucher.' No charge for: a duplicate Registry Card — 'There is no charge for this service' (Handbook). Not set by the state: training tuition — the Department of Education tells candidates to 'select the program to attend and contact them directly for information regarding class start dates and fees'; and the PA State Police criminal-history report and any FBI report, which the candidate obtains from those agencies. A missed exam is charged: 'If you do not report to an examination at your scheduled time, you will be considered a \"no-show\" and fees paid will be forfeited.'",
   "legal_basis": "[{\"citation\": \"42 CFR Part 483, Subpart D (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants) — 42 CFR 483.150, 483.151, 483.152, 483.154, 483.156; and 42 CFR 483.75 / 483.95 on the facility side\", \"what_it_governs\": \"The federal frame every state's registry sits inside: state approval of nurse aide training and competency evaluation programs, the 75-hour minimum with 16 hours of instruction before direct resident contact, the competency evaluation, the state registry itself, and the facility's duty to check it. Pennsylvania's Department of Education directs NATCEP applicants to these sections by name — 'Carefully read the federal and state regulations. See 42 CFR §§ 483.75, 151-154; and 22 PA Code §701' — and the Pennsylvania Candidate Handbook cites 42 CFR 483.75(e)(2) for the 120-day trainee window and 42 CFR 483.75(e)(8) for the 12 hours of annual in-service.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"Nurse Aide Resident Abuse Prevention Training Act, Act 14 of 1997 (P.L. 169), 63 P.S. § 671 et seq.\", \"what_it_governs\": \"Pennsylvania's own nurse aide statute: it requires the OBRA training curriculum to emphasise identifying abuse situations, understanding what abuse is, and methods to prevent resident abuse, and it makes the applicant responsible for obtaining a criminal history record check before enrolling in a nurse aide training program. The Department of Education's NATCEP application describes the Act in exactly those terms and lists 'Convicted of Prohibitive Offenses in 63 P.S. 675' among the items a program's criminal-history policy must cover. The act's own text was not read — the Pennsylvania General Assembly's session-law host was unreachable on 2026-08-14, so everything stated here about Act 14 is attributed to the Department of Education's description of it, not to the statute.\", \"url\": \"https://www.pa.gov/agencies/education/programs-and-services/instruction/career-and-technical-education/nurse-aide-training-program\"}, {\"citation\": \"22 Pa. Code Chapter 701 (Nurse Aide Training Program Applicant Criminal History Record Information) — including 701.12, 701.13 and 701.21\", \"what_it_governs\": \"The criminal-history side of admission to a Pennsylvania nurse aide training program: the report the applicant must obtain, the prohibitive offences at 701.13, and the civil penalty at 701.21 for non-compliance. Named as controlling authority on the Department of Education's Application for Approval of a NATCEP.\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/022/chapter701/chap701toc.html&d=reduce\"}, {\"citation\": \"55 Pa. Code § 1181.521 (Nurse aide training and competency evaluation system) and § 1181.531 (Nurse aide registry system)\", \"what_it_governs\": \"The Department of Human Services regulations that stood up Pennsylvania's OBRA-87 apparatus: § 1181.531(b) records that 'The registry required by OBRA-87 is established and will be maintained by the Department of Health in cooperation with the Department and the Department of Education', and § 1181.521 assigns programme approval to the Department of Education and quotes the federal 'not less than 75 hours' initial-training floor. ⚠ These sections are frozen at their 1988 drafting and read as forward-looking: § 1181.521(c) still says 'The Secretary of HHS has not yet established requirements for these programs', and § 1181.531(d) still says 'Currently the registry contains no names.' They are useful for who-does-what and for the federal hours floor; they are not a current description of the programme.\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter1181/s1181.521.html&d=reduce\"}, {\"citation\": \"28 Pa. Code § 201.20 (Staff development), as amended December 23, 2022, effective July 1, 2023 (52 Pa.B. 8098)\", \"what_it_governs\": \"The annual in-service training a Pennsylvania nursing facility must provide its personnel — the topics in 42 CFR 483.95 plus accident prevention, restorative nursing techniques, emergency preparedness, fire prevention and safety, resident rights including nondiscrimination and cultural competency, and needs identified through a facility assessment. A facility duty, not a condition of registry enrolment, and the section the state-linked Candidate Handbook cites with a superseded topic list.\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/028/chapter201/s201.20.html&d=reduce\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP). The Department of Health names the vendor and the split of duties: 'Test administration is arranged by Credentia', and 'The Pennsylvania Department of Health (DOH) has oversight responsibility of the Registry and contracts with Credentia to do day-to-day management.' The Department of Education disclaims the exam entirely: 'The PA Department of Education has no authority over nurse aide examinations. Any questions or concerns related to nurse aide examinations should be emailed to the PA Department of Human Services.' The state-linked candidate booklet is titled 'Pennsylvania - NNAAP Handbook' and carries 'The 2024 National Nurse Aide Assessment Program (NNAAP®) Written (Oral) Examination Content Outline'.",
   "training_hours": "80 hours total, of which 37.5 hours must be supervised clinical experience. The state-published number is in the Pennsylvania NNAAP Candidate Handbook — the booklet the Department of Health links from its Nurse Aide page as 'Quick Reference - Pennsylvania - NNAAP Handbook' and the Commonwealth's own service page links as 'View the Nurse Aide Candidate Handbook' — which answers the question directly: 'How many hours of training are required for eligibility to take the competency exam? Pennsylvania is an eighty (80) hour state of which thirty-seven point five (37.5) hours must be supervised clinical experience.' The Department of Education's own document reconciles with it exactly: 'NURSE AIDE TRAINING PROGRAM—RECOMMENDED TIME SCHEDULE' (December 2017) sets out an 80-hour column totalling 28.5 classroom + 14.0 laboratory + 37.5 clinical = 80.0, alongside a 120-hour column totalling 40.0 + 25.0 + 55.0 = 120.0. Two caveats the reader is owed. First, the Department of Education's Application for Approval of a NATCEP (March 2026) does not itself state a minimum total — it leaves 'Classroom Hours: Lab Hours: Clinical Hours: Total Course Hours:' as blanks for the program to fill, and directs applicants to 'Carefully read the federal and state regulations. See 42 CFR §§ 483.75, 151-154; and 22 PA Code §701.' Second, the only hours figure that appears in Pennsylvania's regulations is the federal floor quoted back at itself: 55 Pa. Code 1181.521(b)(1) reproduces the federal requirement of 'minimum hours of initial and ongoing training and retraining (including not less than 75 hours in the case of initial training)' — 75, not 80. So the 80/37.5 figures rest on the Handbook and on the Department of Education's published schedule, not on a Pennsylvania regulation reciting them. The one hours rule the Department of Education states as mandatory in its application form is the pre-clinical minimum: 'Ensure the required 16 hours of instruction (classroom and/or skills laboratory) are evident.'",
   "lapse_rule": "Enrolment ends after 24 consecutive months without paid nursing work, and it is a federal rule the state simply relays: 'Under federal requirements, enrollment is no longer valid for any individual who has had a lapse of 24 consecutive months or more in the performance of paid nursing-related services' (Department of Health). Getting back on — two ways, and the retest route is a one-shot: 'Nurse aides have one opportunity to re-test to update a lapsed registry or they may provide proof of employment for pay of at least one documented day (i.e. eight (8) consecutive hours) during each twenty-four (24) month registry period' (Pennsylvania NNAAP Candidate Handbook FAQ). The eligibility article spells out what happens if that single attempt fails: eligibility route 'E-3: Your Pennsylvania nurse aide registration has lapsed because you have not worked providing nursing related services for at least twenty-four (24) consecutive months. An E-3 candidate has one (1) opportunity to successfully pass the NNAAP Examination. If the examination is failed, the candidate must complete nurse aide training again and reapply under eligibility route E-0.' The Department of Health lists the same lapsed-registry route among its four testing-eligibility categories. Separate from lapse — annotation: a substantiated finding of abuse, neglect or misappropriation is recorded against the registry entry, and the Department of Health states the effect plainly: 'If a determination is made that the nurse aide is guilty of abuse, a notation is made on the individual's file on the Nurse Aide Registry. This prohibits future employment by that person in a nursing home.' Only one annotation category is reversible: 'Only those annotated for \"neglect\" may request reinstatement considerations after one (1) full year from the date of annotation on the Registry. The only other consideration will be given to those that a court of law overturned the Department's decision.'",
   "reciprocity": "Pennsylvania calls it reciprocity and runs it as an application, not an automatic transfer. Department of Health: 'If you are a nurse aide currently listed on another state's nurse aide (or equivalent) registry as active and in good standing (according to federal nursing home nurse aide statutes), and you are seeking enrollment on the Pennsylvania Nurse Aide Registry, you will need to submit a reciprocity application.' The application is filed through a new Credentia Platform account, and the contractor's Pennsylvania page adds: 'If you are a Nurse Aide in active and good standing on another state's Nurse Aide (or equivalent) Registry you may submit an application through reciprocity to enroll on the Pennsylvania Nurse Aide Registry... You will use this new account to access your Pennsylvania Registry status information.' The trap, stated by the state's own Handbook: 'If you are lapsed on another state registry, you have to be updated on your original state registry to be eligible for reciprocity' — a lapsed out-of-state aide cannot reciprocate into Pennsylvania, and instead tests here under eligibility route E-4 ('You are listed on another state's nurse aide registry, but your registry has lapsed because you have not worked providing nursing-related services for at least 24 consecutive months. An E-4 candidate has one (1) opportunity to successfully pass the NNAAP Examination. If the examination is failed, the candidate must complete nurse aide training again and reapply under eligibility route E-0'). Pennsylvania also checks the other direction before you work: 'Facilities are required to verify that nurse aides are in good standing on all other state registries prior to allowing them to work in that capacity.' Neither the Department of Health's pages nor the Handbook states a fee for the reciprocity application, a processing time, or an endorsement-by-training-equivalence route for someone trained out of state who was never registered anywhere — all three were checked and none is published.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Pennsylvania Department of Health — Nurse Aide (the registry landing page). Establishes 'A nurse aide who is not enrolled or in good standing on the registry may not be employed in a nursing care facility that receives Medicare or Medicaid reimbursement', the employer verification duty, the link to the Nurse Aide Registry Online lookup, the bulk-registry request route through the Department's contractor, the abuse-reporting and annotation procedure ('a notation is made on the individual's file on the Nurse Aide Registry. This prohibits future employment by that person in a nursing home'), the referral of licensed staff to the Department of State, and the link to the 'Quick Reference - Pennsylvania - NNAAP Handbook'.\", \"url\": \"https://www.pa.gov/agencies/health/business-registration-and-regulation/nurse-aide\"}, {\"label\": \"Pennsylvania Department of Health — Nurse Aide Enrolling and Testing. Establishes the four testing-eligibility categories (including the temporary-nurse-aide/Attestation Form route), the two-part exam and its question counts, the 30-minute skills window and two-hour written window, 'You are permitted three attempts by State and Federal regulations', the two-year post-training testing window, the fee-payer rule, the 130-hour/130-hour reimbursement schedule, 'The Pennsylvania Department of Health (DOH) has oversight responsibility of the Registry and contracts with Credentia to do day-to-day management', the reciprocity application requirement, the 24-month renewal work requirement and 90-day notice, the Home Care Agency/Registry addition to the DOH Approved Employer List, and the address/name-change duty.\", \"url\": \"https://www.pa.gov/agencies/health/business-registration-and-regulation/nurse-aide/nurse-aide-testing\"}, {\"label\": \"Commonwealth of Pennsylvania — Apply to Become a Nurse Aide (the state's own service page). Establishes the two-step path: 'To become a nurse aide In Pennsylvania and to have your name on the PA Nurse Aide Registry, you must: Complete a Pennsylvania Department of Education approved nurse aide training program [and] Pass the nurse aide exam', and links the approved-program list, the Candidate Handbook and the registry lookup.\", \"url\": \"https://www.pa.gov/services/health/apply-to-become-a-nurse-aide\"}, {\"label\": \"Pennsylvania Department of Education — Nurse Aide Training Program. Establishes that PDE approves the training programs and publishes the approved-program list by county, the enrolment conditions (age 16, PA State Police CHRI in the year before training, FBI report for non-residents of two years, physical examination with 2-step Mantoux, the 40-pound lifting expectation, basic English math/reading/writing), the facility payment and 12-month reimbursement rules, and 'The PA Department of Education has no authority over nurse aide examinations.'\", \"url\": \"https://www.pa.gov/agencies/education/programs-and-services/instruction/career-and-technical-education/nurse-aide-training-program\"}, {\"label\": \"Pennsylvania Department of Education — nurse aide training program—recommended time schedule (December 2017, PDF). The state's own hour distribution: an 80-hour program at 28.5 classroom + 14.0 laboratory + 37.5 clinical, and a 120-hour program at 40.0 + 25.0 + 55.0, broken out across 14 units.\", \"url\": \"https://www.pa.gov/content/dam/copapwp-pagov/en/education/documents/instruction/career-and-technical-education/nurse-aide-training-program/recommended%20time%20schedule.pdf\"}, {\"label\": \"Pennsylvania Department of Education — Application for Approval of Nurse Aide Training and Competency Evaluation Program (March 2026, Word document). Establishes the controlling-authority list ('See 42 CFR §§ 483.75, 151-154; and 22 PA Code §701'), the six-month approval timeline and site inspection, 'Ensure the required 16 hours of instruction (classroom and/or skills laboratory) are evident', the blank Classroom/Lab/Clinical/Total Course Hours fields, the CHRI policy checklist referencing 22 Pa. Code 701.13 and 63 P.S. 671/675, and the description of Act 14 of 1997.\", \"url\": \"https://www.pa.gov/content/dam/copapwp-pagov/en/education/documents/instruction/career-and-technical-education/nurse-aide-training-program/application%20for%20approval%20of%20natcep.docx\"}, {\"label\": \"Pennsylvania NNAAP Candidate Handbook — Quick Reference (the booklet the Department of Health links as 'Quick Reference - Pennsylvania - NNAAP Handbook' and the Commonwealth service page links as 'View the Nurse Aide Candidate Handbook'). Establishes the division of labour among the three Pennsylvania agencies, including 'The Pennsylvania Department of Health administers the Commonwealth contract to provide nurse aide registry services' and 'The Pennsylvania Department of Education approves Pennsylvania nurse aide training programs.'\", \"url\": \"https://kb-pa.credentia.com/en/article/quick-reference\"}, {\"label\": \"Pennsylvania NNAAP Candidate Handbook — Frequently Asked Questions. Establishes 'Pennsylvania is an eighty (80) hour state of which thirty-seven point five (37.5) hours must be supervised clinical experience', the 30-day and 90-day background-clearance work allowances, the 120-day trainee window and its reset on changing employers, the one-documented-day renewal rule, the one re-test opportunity for a lapsed registry, the reciprocity precondition that a lapsed out-of-state aide must first be updated on the original state registry, 'There are no \\\"training requirements\\\" to renew your registry', the annotation-reinstatement rule limited to neglect after one year, and 'If an individual fails the state competency examination three times, they may re-train and have another three (3) opportunities.'\", \"url\": \"https://kb-pa.credentia.com/en/article/faqfrequently-asked-questions\"}, {\"label\": \"Pennsylvania NNAAP Candidate Handbook — Exam Fees. Establishes the fee table ($135 Written & Skills or Oral & Skills; $50 written re-test; $50 oral re-test; $85 skills re-test), 'Fees are not refundable', 'Under Federal and Pennsylvania laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test', the accepted payment methods, and the 130-hour/130-hour pro rata reimbursement with 'The hours start accruing when the individual has successfully tested and is listed on the registry.'\", \"url\": \"https://kb-pa.credentia.com/en/article/exam-fees\"}, {\"label\": \"Pennsylvania NNAAP Candidate Handbook — Eligibility Criteria. Establishes the minimum age of 16 for employment as a nurse aide, the background-check and exclusionary-conviction conditions, eligibility routes E-0 (PDE-approved training within 24 months), E-3 (lapsed Pennsylvania registration, one attempt) and E-4 (lapsed out-of-state registry, one attempt), and the 120-day non-registered employment allowance citing 42 CFR 483.75(e)(2).\", \"url\": \"https://kb-pa.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"Pennsylvania NNAAP Candidate Handbook — The Registry. Establishes the 90-day renewal notice, the one-documented-day work requirement and the approved facility types, the exclusion of self-employment/private duty/doctors' offices, the 24-month Registry Card validity, the name/address/SSN change procedure, 'There is no charge for this service' for a duplicate Registry Card, the 24-month lapse rule, and the note that the 12-hour annual in-service duty and the 28 Pa. Code 201.20 topic list 'are not requirements inherent to the Nurse Aide Registry and have no impact on registry renewal.'\", \"url\": \"https://kb-pa.credentia.com/en/article/the-registry\"}, {\"label\": \"55 Pa. Code § 1181.521 (Nurse aide training and competency evaluation system), Pennsylvania Code official site. Quotes the federal 'not less than 75 hours in the case of initial training' floor and assigns programme review and approval to the Department of Education.\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter1181/s1181.521.html&d=reduce\"}, {\"label\": \"55 Pa. Code § 1181.531 (Nurse aide registry system), Pennsylvania Code official site. Establishes that 'The registry required by OBRA-87 is established and will be maintained by the Department of Health in cooperation with the Department and the Department of Education', and that 'An individual who is currently on a nurse aide registry in another state and who seeks listing on Pennsylvania's registry should contact the registry.'\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter1181/s1181.531.html&d=reduce\"}, {\"label\": \"28 Pa. Code § 201.20 (Staff development), Pennsylvania Code official site. The live, post-July-2023 text of the facility in-service rule the Candidate Handbook cites with a superseded topic list.\", \"url\": \"https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/028/chapter201/s201.20.html&d=reduce\"}, {\"label\": \"Pennsylvania Nurse Aide Registry Online (public lookup), linked by the Department of Health as the tool that 'allows facilities to use the Internet to check the status of any nurse aide on the registry.'\", \"url\": \"https://cna365.examroom.ai/registry/?StateCode=PA\"}]",
   "page_url": "https://licensingatlas.com/cna/pa-cna/"
  },
  {
   "page_id": "ri-cna",
   "state": "Rhode Island",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Rhode Island Department of Health (RIDOH), Center for Health Professions Regulation — Nursing Assistant licensing, advised by the Nursing Assistant Advisory Board. The Department is the \"certifying agency\" named in the statute: \"'Certifying agency' means the state department of health\" (R.I. Gen. Laws § 23-17.9-2(a)(1)). Examination administration is contracted out — the Department directs candidates to register for both the written and skills examinations through Credentia.",
   "board_url": "https://health.ri.gov/nursing-assistant",
   "application_url": "https://health.ri.gov/sites/g/files/xkgbur1006/files/applications/NursingAssistantExam.pdf",
   "renewal_cycle": "Biennial, on a fixed statewide date rather than on the licensee's own anniversary. \"Unless suspended or revoked, this license shall expire biennially (every two (2) years) on June 30 of every other year following the date of issuance of the original registration\" (§ 22.5.5(A)). The filing deadline is two weeks before that: \"Every nursing assistant and/or medication aide who wishes to renew his or her license shall file a renewal application with the Department together with the renewal fee... before June 15\" (§ 22.5.5(B)), and \"Upon receipt of such renewal application and payment of the fee, the Department shall renew the license effective July 1, and expiring June 30, two (2) years later\" (§ 22.5.5(C)). The Department renews online and states: \"Renewal notices are sent out 60 days before your expiration date.\" What keeps the license alive is work plus in-service hours, and Rhode Island asks for both: \"A nursing assistant seeking renewal shall have been employed as a nursing assistant for at least eight (8) hours within the prior twenty-four (24) months and have completed twelve (12) hours of in-service training per year at the facility where employed; or have successfully completed a nursing assistant training program and passed the exam for licensure within the past twenty-four (24) months\" (§ 22.5.5(E)). Where the work must have been done (§ 22.5.5(G)): a Rhode Island health care facility licensed under R.I. Gen. Laws ch. 23-17; an assisted living residence licensed under ch. 23-17.4; an adult day services program licensed under § 23-1-52; or employment by a licensed nursing service agency — and \"Private duty employment does not meet this employment requirement.\" How it is proved: by attestation, subject to audit — \"A nursing assistant applicant seeking renewal shall attest that he or she has been employed within the previous twenty-four (24) months when completing the online renewal form. Renewal applicants are subject to audit and must retain proof of completion of in-service hours and/or Continuing Education Units for a three (3) year period\" (§ 22.5.5(J)). The statute adds a plain-language backstop: renewals \"shall be granted as a matter of course, upon payment of a fee\" unless the Department finds grounds for suspension or revocation (R.I. Gen. Laws § 23-17.9-7).",
   "ce_hours": "No continuing education units are required of a Rhode Island nursing assistant. What is required at renewal is twelve (12) hours of in-service training per year, delivered at the facility where the aide works: a nursing assistant seeking renewal must have worked at least eight hours in the prior twenty-four months \"and have completed twelve (12) hours of in-service training per year at the facility where employed\" (216-RICR-40-05-22, § 22.5.5(E)). The same twelve-hour figure governs reinstatement after a lapse: an applicant must attest to \"completion of twelve (12) hours per twelve (12) month period of in-service training\" (§ 22.5.5(M)(1)(d)). Proof is not filed with the renewal but must be kept: renewal applicants \"are subject to audit and must retain proof of completion of in-service hours and/or Continuing Education Units for a three (3) year period\" (§ 22.5.5(J)). Do not confuse this with the medication aide rule, which is a different credential and a different number: a medication aide must \"submit proof of four (4) Continuing Education Units\" for renewal (§ 22.5.5(F)), and \"in the preceding two (2) years the licensee has completed four (4) required continuing education hours\" (§ 22.5.5(K)(1)). Twelve in-service hours a year is the nursing assistant's obligation; four continuing education hours per two-year cycle is the medication aide's. Sources checked for a nursing assistant continuing-education requirement and not found: 216-RICR-40-05-22 in full, R.I. Gen. Laws §§ 23-17.9-1 through 23-17.9-7, the Department's Nursing Assistant page, and both Department application packets.",
   "exam": "Two parts, both required, and Rhode Island splits them across two settings. The Department: \"You must Register Online to schedule the written and skills examinations. The written portion of the exam is now taken online and the skills portion will be assigned to a Regional Testing location in Rhode Island, based on availability.\" Written: seventy (70) multiple-choice questions in English, with two (2) hours allowed. Oral alternative: an Oral Examination may be taken instead of the written one and must be requested when the application is filled out; it has two parts — sixty (60) multiple-choice questions, each read twice, plus ten (10) questions testing recognition of common long-term-care words, each word read three times — and both parts must be passed. A Spanish Oral Examination exists, in which the ten word-recognition items are read in Spanish and matched to the English word. Skills: \"you will be asked to perform five (5) randomly selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator.\" (Those exam-mechanics details are from the Rhode Island candidate handbook published by the Department's testing contractor, not from Rhode Island regulation.) what the regulation requires of the practical test, in Rhode Island's own words: it must test communication and interpersonal skills, infection control, safety emergency procedures, promotion of patients' independence, respecting patients' rights, basic nursing skills, mental health and social service needs, care of cognitively impaired patients, and basic restorative services — and \"Where appropriate, skills demonstration shall be performed on a real patient, or 'pseudo-patient,' but shall not be performed on a mannequin\" (§ 22.7.1(J)(2)-(3)). Attempts: three (§ 22.5.4(C)). Deadline: within one year of the date training began (§ 22.5.4(B)). Scheduling is the programme's job, not only the candidate's: \"Paperwork and scheduling required for a candidate to sit for the State Nursing Assistant examination shall be prepared by the nursing assistant training program, and testing scheduled with the testing provider within ten (10) days after the applicant's completion of the program\" (§ 22.7.1(D)(3)). Nursing students take the written examination only and are exempt from the skills portion (§ 22.5.1(D); Department application).",
   "fees": "State fees (216-RICR-10-05-2, Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health, effective 03/25/2026): Nursing Assistant: Application $35.00 (R.I. Gen. Laws §§ 23-17.9-6, 23-1-54); Nursing Assistant: Renewal $35.00 (§§ 23-17.9-7, 23-1-54). The Department's own application form matches exactly: \"Check or money order (preferred), made payable (in U.S. funds only) to the RI General Treasurer in the amount of $35.00... THIS APPLICATION FEE IS NONREFUNDABLE.\" On the programme side the same schedule sets Nursing Assistant Training Program: Application $325.00 and Renewal $325.00 — a programme cost, not a candidate cost. The Medication Aide license carries its own $35.00 application and $35.00 renewal. Examination fees are separate and are not state fees: the Rhode Island candidate handbook published by the Department's testing contractor lists Written Exam $55, English Oral Exam $55, Spanish Oral Exam $55, Skills Exam $110, states \"You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test,\" that \"Fees are not refundable,\" and that \"Under federal and Rhode Island laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test.\" What the applicant may get back: the $35.00 application fee, refunded by the employer, where the aide \"is employed by a health care facility at the time of application and is continuously employed by the same facility for six (6) months after the license is issued\" (§ 22.5.3(D)(1)(b)(4)). Not set by the state: training tuition — the Department tells candidates to \"Contact a training program directly to find out how to enroll, when classes are offered, and how much classes cost\" — and the Rhode Island Attorney General's BCI report, which the applicant obtains from that office. No separate reinstatement fee is published for nursing assistants: § 22.5.5(M)(1)(b) refers to a \"Reinstatement processing fee as set forth in the Fee Structure,\" but the Fee Structure's nursing assistant block lists only Application and Renewal at $35.00 each (both checked), so this page states no reinstatement figure.",
   "legal_basis": "[{\"citation\": \"R.I. Gen. Laws ch. 23-17.9 (Registration of Nursing Assistants) — §§ 23-17.9-1 through 23-17.9-14\", \"what_it_governs\": \"Rhode Island's own nurse aide statute: the declaration of purpose (§ 23-17.9-1); the definitions, the supervision rule and the personal-care-attendant and nursing-student inapplicability provisions (§ 23-17.9-2); training and competency evaluation programmes and the programme certification fee (§ 23-17.9-3); duties (§ 23-17.9-4); the qualifying examination, its exemptions, who pays the processing fee and the six-month refund (§ 23-17.9-5); the certificate of registration, the one-year training-to-examination clock and the public register (§ 23-17.9-6); biennial renewal (§ 23-17.9-7); disciplinary proceedings, penalties and enforcement (§§ 23-17.9-8 to 23-17.9-10); the advisory board (§ 23-17.9-13); and the rulemaking authority the current regulation is promulgated under (§ 23-17.9-14).\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/INDEX.htm\"}, {\"citation\": \"216-RICR-40-05-22 — Nursing Assistants, Medication Aides, and the Approval of Nursing Assistant and Medication Aide Training Programs (Rhode Island Department of Health), active, effective 02/01/2023\", \"what_it_governs\": \"The operative rule for this credential: definitions and levels of nursing assistant (§§ 22.3, 22.4); the employment bar and the 'N.A.' title rule (§ 22.5); supervision and the nursing-student exemption (§ 22.5.1); qualifications, the BCI and the application contents (§ 22.5.3); licensure by examination, the one-year clock, three attempts and the 120-day temporary permit (§ 22.5.4); issuance, biennial June 30 expiry, the June 15 filing deadline, the eight-hours-of-work and twelve-hours-of-in-service renewal conditions, lapse and reinstatement (§ 22.5.5); grounds for discipline (§ 22.6); training programme approval, the 120-clock-hour / 40-practical-hour standard, the 16-hour pre-contact rule and the practical examination content (§ 22.7.1); the Advisory Board (§ 22.9); and the duty lists and curriculum outline (§ 22.12). Promulgated under R.I. Gen. Laws § 23-17.9-14 and adopting 42 C.F.R. § 483.152 (2017) by reference (§ 22.2).\", \"url\": \"https://rules.sos.ri.gov/regulations/part/216-40-05-22\"}, {\"citation\": \"216-RICR-10-05-2 — Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health, active, effective 03/25/2026\", \"what_it_governs\": \"The dollar figures the nursing assistant regulation refers to by cross-reference: Nursing Assistant Application $35.00, Nursing Assistant Renewal $35.00, Nursing Assistant Training Program Application and Renewal $325.00 each, and the parallel Medication Aide figures, each row citing its own R.I. Gen. Laws authority.\", \"url\": \"https://rules.sos.ri.gov/regulations/part/216-10-05-2\"}, {\"citation\": \"42 C.F.R. § 483.152 (2017), adopted and incorporated by reference at 216-RICR-40-05-22, § 22.2\", \"what_it_governs\": \"The federal requirements for approval of a nurse aide training and competency evaluation programme, which Rhode Island adopts \\\"not including any further editions or amendments thereof and only to the extent that the provisions therein are not inconsistent with these Rules and Regulations.\\\" That version-pinned adoption is itself worth noting: Rhode Island's rule is tied to the 2017 text, not to whatever the C.F.R. says today.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP). The Department of Health names it on its Nursing Assistant page — \"Register for the Exams through Credentia - You must Register Online to schedule the written and skills examinations\" — and on the application form: \"Please visit https://credentia.com/test-takers/ri to create a login and schedule both your written and skills examinations.\" The regulation itself does not name a vendor: it says only that \"The nursing assistant written and practical examinations shall be selected and approved by the Director or designee\" (§ 22.5.4(A)), and elsewhere refers to \"the National Nursing Assistant Assessment Program or a nursing assistant written and practical examination selected and approved by the Director or his/her designee\" (§ 22.5.4(D)) — which leaves room for more than one approved administrator. That was deliberate: the Secretary of State's rulemaking record for the 02/01/2023 amendment gives as its Purpose and Reason that \"the goal is to open the market to additional test administrators, as the inability of the currently contracted vendor to meet testing demand from the recent graduates of nursing assistant training programs has created a bottleneck limiting their entry into the industry.\" As of August 16, 2026, the Department names only Credentia. Two different Credentia phone numbers appear in official material, and this page does not choose between them: the Department's page says \"Contact Credentia Call Center at 800-274-2900\", while the Rhode Island candidate handbook's Quick Reference gives \"Call 888-204-6249.\"",
   "training_hours": "120 clock hours total — 80 classroom and 40 clinical. The Department states it on its own application form: \"Effective 01/01/2019 training hours must contain 80 classroom hours and 40 clinical hours for a total of a 120 hour program\" (Application for License as a Nursing Assistant By Examination, revised 04/09/2025), repeated on the same form as \"Effective 01/01/2019 RI Training Programs must provide 80 classroom and 40 Clinical hours. (120 total).\" The regulation sets the same floor for programme approval: \"The nursing assistant training program shall consist of no less than one hundred twenty (120) clock hours including no less than forty (40) hours of practical training integrated with the classroom topics and under supervision\" (216-RICR-40-05-22, § 22.7.1(D)(1)), and the curriculum outline at § 22.12.2(A) states the same split as a \"Minimum requirement of: 1. Eighty (80) classroom hours 2. Forty (40) hours of practical experience.\" That is 45 hours above the federal floor of 75. ⚠ A number that conflicts with itself inside the same regulation, recorded both ways: § 22.12.2(H)(1), in the practical-training paragraph of the same curriculum outline, says \"Each student must satisfactorily complete twenty (20) hours of practical training under supervision.\" Twenty, not forty. Three other places in Rhode Island's own material say forty — § 22.7.1(D)(1), § 22.12.2(A)(2), and the Department's application form — and the Department's own clinical-documentation form has the programme instructor certify that the student \"did complete the required forty (40) hours of clinical training.\" This page reports the 40-hour figure as the operative one and flags the 20-hour sentence rather than deleting it. (The 20-hour figure is operative in a different place: the endorsement route for out-of-state training requires a 100-hour programme \"including a minimum of twenty (20) hours of practical clinical training under supervision\" — § 22.5.3(A)(4). Do not conflate the two.) before patient contact: \"At least sixteen (16) hours of classroom instruction shall be required prior to a trainee's direct involvement with patients\" (§ 22.7.1(D)(4)). Online programmes: \"Online nursing assistant training programs may offer the required eighty (80) hours of didactic training via the Internet. The forty (40) hours of practical training shall be provided by the employing facility\" (§ 22.7.1(D)(1)(a)). A programme conducted inside a health care facility \"shall be completed within ninety (90) days\" (§ 22.7.1(D)(2)).",
   "lapse_rule": "Two doors, and which one you use depends on how long the license has been lapsed. Under two years: \"Any nursing assistant and/or medication aide whose license lapses for a period of less than two (2) years may be reinstated by the Department upon submission of an application and payment of the renewal fee(s)... unless the registration has been suspended or revoked\" (§ 22.5.5(D)). Two years or longer: \"Any nursing assistant and/or medication aide whose license lapses for a period of two (2) years or longer, and who cannot provide proof of employment in accordance with §§ 22.5.5(G) and (H) of this Part, shall be required to successfully complete the nursing assistant training and/or medication aide training program, and all required examinations, prior to being reinstated\" (§ 22.5.5(I)) — note the escape hatch built into that sentence: proof of qualifying employment can still save a license lapsed two years or more. A separate reinstatement route for an aide who kept working elsewhere (§ 22.5.5(M)(1)): a nursing assistant previously licensed in Rhode Island in good standing, who let the license lapse but \"has been working as a nursing assistant in another State or jurisdiction within the two (2) years immediately preceding the application for reinstatement and has completed twelve (12) hours of in-service per twelve (12) month period,\" may apply with a photocopy of the active out-of-state license, the reinstatement processing fee, an attestation of eight hours of Rhode Island-qualifying employment within the past two years (\"license must be current at the time of employment\") in a nursing home, hospital, home care agency, assisted living residence, adult day services program or nursing service agency, an attestation of the twelve in-service hours per year, and \"Verification from current State of licensure that the applicant for reinstatement is and has been in good standing in that jurisdiction.\" The Rhode Island candidate handbook published by the Department's testing contractor states the same two-year fork from the testing side: a license lapsed more than twenty-four months requires re-training and re-testing under eligibility route E-1, and one lapsed less than twenty-four months requires contacting the Department with \"evidence of your work history as a nursing assistant of at least eight (8) hours in the prior twenty-four (24) months.\" Discipline is a different thing from lapse: a nursing assistant's record of discipline stays on the registry for two years, after which the aide may petition the Department in writing to have it removed if the employment and personal history shows no pattern of unprofessional conduct and the original finding was a singular occurrence (§ 22.5.5(L)).",
   "reciprocity": "Rhode Island calls it endorsement, runs it as a full application, and offers two qualifying routes. The regulation's routes are § 22.5.3(A)(3) — \"Possession of a current license as a nursing assistant in good standing in another State or jurisdiction that includes successful completion of a State-approved training program that meets or exceeds Rhode Island Nursing Assistant training program requirements, and successful completion of a State-approved nursing assistant exam, and provides documentation of the equivalent of three (3) months of full-time work experience as a nursing assistant\" — and § 22.5.3(A)(4), \"Successful completion of a one hundred (100) hour State-approved training program in another State or jurisdiction that includes a minimum of twenty (20) hours of practical clinical training under supervision, and successful completion of a nursing assistant examination.\" The Department's By Endorsement application (revised 10/24/2024) turns those into a document checklist: the $35.00 fee, a copy of a driver's license or state ID, an original Rhode Island Attorney General BCI dated within four months, \"Evidence of a current license as a Nursing Assistant in another state,\" a completed Interstate Verification Form that the applicant sends to the other state's board, and then either a certificate or school letter stating the number of hours — which \"MUST state the number of hours AND must include a minimum of 20 hours of practical clinical training under supervision\" — OR an employer's statement of \"at least 3 months of full-time work experience within the last year as a Nursing Assistant\" on the enclosed Employment Verification Form, which \"must include one (1) hour per month of in-service training for each month you have been employed.\" The application must be mailed: \"DO NOT HAND DELIVER - APPLICATION MUST BE MAILED.\" Note the asymmetry the endorsement route creates: Rhode Island's own programmes must be 120 hours, but it will endorse a 100-hour out-of-state programme. Not published, and searched for in the regulation, the statute, the Department's Nursing Assistant page and both application packets: a processing time for endorsement applications, a separate endorsement fee (the $35.00 application fee is the only figure given), and any route for a person trained out of state who was never licensed or registered anywhere.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Rhode Island Department of Health — Nursing Assistant (the Department's own landing page for this credential). Establishes the two-track presentation of Nursing Assistant and Medication Aide, \\\"Register for the Exams through Credentia - You must Register Online to schedule the written and skills examinations. The written portion of the exam is now taken online and the skills portion will be assigned to a Regional Testing location in Rhode Island, based on availability\\\", \\\"Renewal notices are sent out 60 days before your expiration date\\\", \\\"You must be licensed as a Nursing Assistant to be licensed as a Medication Aide\\\", the license-application phone numbers 401-222-5888 and 401-222-2828, \\\"Contact Credentia Call Center at 800-274-2900\\\", and the links to the initial applications, online renewals, licensing fees, the Nursing Assistant Advisory Board and license verification.\", \"url\": \"https://health.ri.gov/nursing-assistant\"}, {\"label\": \"216-RICR-40-05-22 — Nursing Assistants, Medication Aides, and the Approval of Nursing Assistant and Medication Aide Training Programs, on the Rhode Island Department of State's Code of Regulations site. Active, effective 02/01/2023, promulgated under R.I. Gen. Laws § 23-17.9-14. Establishes the license definition at § 22.3(A)(15), the employment bar and 'N.A.' abbreviation rule at § 22.5, the nursing-student exemption at § 22.5.1(D), the qualification routes at § 22.5.3(A), the BCI requirement, the one-year clock and three attempts at § 22.5.4(B)-(C), the 120-day Temporary Permit at § 22.5.4(D), the June 30 / June 15 / July 1 renewal mechanics and the eight-hour work and twelve-hour in-service conditions at § 22.5.5, the lapse and reinstatement rules at § 22.5.5(D), (I) and (M), the 120-clock-hour / 40-practical-hour training standard at § 22.7.1(D)(1), the 16-hour pre-contact rule at § 22.7.1(D)(4), the no-mannequin skills rule at § 22.7.1(J)(3), the curriculum outline at § 22.12.2 (including the conflicting twenty-hour sentence at § 22.12.2(H)(1)), and the excluded duties at § 22.12.1(C). The page also carries the rulemaking record, including the 02/01/2023 amendment's stated Purpose and Reason.\", \"url\": \"https://rules.sos.ri.gov/regulations/part/216-40-05-22\"}, {\"label\": \"216-RICR-10-05-2 — Fee Structure for Licensing, Laboratory and Administrative Services Provided by the Department of Health, active, effective 03/25/2026. Its nursing assistant block establishes Application $35.00 (§§ 23-17.9-6, 23-1-54), Renewal $35.00 (§§ 23-17.9-7, 23-1-54), Training Program Application $325.00 and Training Program Renewal $325.00 (§§ 23-17.9-3, 23-1-54), plus the Medication Aide rows at $35.00 / $35.00 / $325.00 / $325.00.\", \"url\": \"https://rules.sos.ri.gov/regulations/part/216-10-05-2\"}, {\"label\": \"Rhode Island Department of Health — Instructions and Application for License As A Nursing Assistant By Examination (RI Nursing Assistant Training Program), revised 04/09/2025. Establishes \\\"Effective 01/01/2019 training hours must contain 80 classroom hours and 40 clinical hours for a total of a 120 hour program\\\", the $35.00 non-refundable fee payable to the RI General Treasurer, the four-month BCI currency rule, the nursing-student written-examination-only route with the Dean's signature and \\\"3 opportunities\\\", \\\"ONLY Nursing Assistants applying by Examination through a Nursing Assistant Training Program will be issued a 120 day temporary permit\\\" with \\\"No extensions\\\", the mailing-only rule, \\\"Applications are valid for a 1 year period\\\", the ten-day address-change duty, \\\"Allow a minimum of 8 weeks for the entire licensure process\\\", \\\"you may NOT practice as a Nursing Assistant in Rhode Island until you have received your license\\\", the military expedition form under R.I. Gen. Laws § 5-88-1 et seq., and the mandatory clinical-training documentation form certifying \\\"the required forty (40) hours of clinical training\\\".\", \"url\": \"https://health.ri.gov/sites/g/files/xkgbur1006/files/applications/NursingAssistantExam.pdf\"}, {\"label\": \"Rhode Island Department of Health — Instructions and Application for License As A Nursing Assistant By Endorsement, revised 10/24/2024. Establishes the endorsement document checklist: current out-of-state nursing assistant license, the Interstate Verification Form, and either \\\"Evidence of 100 Nursing Assistant Training Program Hours... must include a minimum of 20 hours of practical clinical training under supervision\\\" or \\\"Evidence of 3 Months Employment as a Nursing Assistant... at least 3 months of full-time work experience within the last year\\\" with \\\"one (1) hour per month of in-service training\\\", plus the same $35.00 fee, four-month BCI and mail-only filing.\", \"url\": \"https://health.ri.gov/sites/g/files/xkgbur1006/files/applications/NursingAssistantEndorsement.pdf\"}, {\"label\": \"R.I. Gen. Laws § 23-17.9-2 (Definitions — Supervision of nursing assistants — Inapplicability of chapter), Rhode Island General Assembly. Establishes \\\"'Certifying agency' means the state department of health\\\", the definition of nursing assistant as \\\"a nurses' aide, orderly, or home health aide\\\", the supervision rule, the personal-care-attendant carve-out at subsection (c), and the matriculated-nursing-student carve-outs at subsections (d) and (e).\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/23-17.9-2.htm\"}, {\"label\": \"R.I. Gen. Laws § 23-17.9-6 (Registration). Establishes \\\"Every nursing assistant being employed as a nursing assistant or offering services as a nursing assistant must obtain a certificate of registration issued by the department\\\", the one-year training-and-examination clock and the retrain-and-retest consequence, the public register open to inspection, and \\\"if required by federal mandate the department will also keep a separate nurse aide registry.\\\"\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/23-17.9-6.htm\"}, {\"label\": \"R.I. Gen. Laws § 23-17.9-5 (Qualifying examination). Establishes the examination exemptions for home health aides/homemakers qualified under ch. 23-17.7 and for classes exempted by federal statute or regulation, the manual-skills-proficiency provision, and the rules on who pays the processing fee and the six-month refund.\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/23-17.9-5.htm\"}, {\"label\": \"R.I. Gen. Laws § 23-17.9-7 (Renewal of certificate of registration). Establishes biennial renewal on Department forms and that renewals \\\"shall be granted as a matter of course, upon payment of a fee\\\" unless grounds for suspension or revocation are found.\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/23-17.9-7.htm\"}, {\"label\": \"R.I. Gen. Laws § 23-17.9-3 (Training and competency evaluation program for levels of nursing assistants). Establishes that training and competency-evaluation standards \\\"shall be consistent with federal statutory and regulatory requirements and shall be defined according to the rules and regulations promulgated by the department of health\\\", and the biennial programme certification fee.\", \"url\": \"https://webserver.rilegislature.gov/Statutes/TITLE23/23-17.9/23-17.9-3.htm\"}, {\"label\": \"Rhode Island Department of Health — Online Verification Site (the public license lookup the Department links as \\\"Verify a Nursing Assistant License\\\"). Its live form controls establish the search-by list and the nursing assistant / medication aide license-type entries shown under Verify a license on this page.\", \"url\": \"https://healthri.mylicense.com/verification/\"}, {\"label\": \"Rhode Island Nurse Aide candidate handbook — Exam Fees (published by Credentia, the testing contractor the Department directs candidates to). Establishes Written Exam $55, English Oral Exam $55, Spanish Oral Exam $55, Skills Exam $110, \\\"You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test\\\", \\\"Fees are not refundable\\\", and \\\"Under federal and Rhode Island laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test.\\\"\", \"url\": \"https://kb-ri.credentia.com/en/article/exam-fees\"}, {\"label\": \"Rhode Island Nurse Aide candidate handbook — Exam Overview. Establishes the seventy-question two-hour written examination, the two-part oral examination (sixty multiple-choice questions read twice plus ten word-recognition questions read three times), the Spanish oral variant, and the five randomly selected skills rated by a Nurse Evaluator.\", \"url\": \"https://kb-ri.credentia.com/en/article/exam-overview\"}, {\"label\": \"Rhode Island Nurse Aide candidate handbook — Eligibility Criteria. Establishes the minimum age (\\\"you must be sixteen (16) years of age or older\\\"), the background-check condition, the one-year-from-start-of-training testing window, the nursing-student route requiring a signed letter from the nursing school and only the written examination, and the two-year lapse fork.\", \"url\": \"https://kb-ri.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"Rhode Island Nurse Aide candidate handbook — The Registry. Establishes the change-of-name and change-of-address duty, that renewal runs through the Rhode Island Department of Health rather than the vendor, the eight-hours-in-twenty-four-months renewal condition, the federal twenty-four-month lapse rule, and the description of endorsement from another state's registry.\", \"url\": \"https://kb-ri.credentia.com/en/article/the-registry\"}, {\"label\": \"Rhode Island Nurse Aide candidate handbook — Quick Reference. Establishes the Credentia contact details used for scheduling (including \\\"Call 888-204-6249\\\") and the Rhode Island Department of Health address and phone at Three Capitol Hill Room 104, Providence.\", \"url\": \"https://kb-ri.credentia.com/en/article/quick-reference\"}, {\"label\": \"Credentia — Rhode Island Nurse Aide test-taker page, the address the Department's application form sends candidates to (\\\"Please visit https://credentia.com/test-takers/ri to create a login and schedule both your written and skills examinations\\\").\", \"url\": \"https://credentia.com/test-takers/ri/\"}]",
   "page_url": "https://licensingatlas.com/cna/ri-cna/"
  },
  {
   "page_id": "sc-cna",
   "state": "South Carolina",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "South Carolina Department of Health and Human Services (SCDHHS), Division of Long Term Living — South Carolina Nurse Aide Registry and Nurse Aide Training and Competency Evaluation Program. SCDHHS states its own role: \"The South Carolina Department of Health and Human Services (SCDHHS) is designated to have over-site of the South Carolina Nurse Aide Training and Competency Evaluation Program. The SCDHHS must ensure that the approved Nurse Aide Training Programs and the Nurse Aide Registry is in compliance with the Code of Federal Regulations as stated in 42CFR483.150-158 and with the South Carolina Core Curriculum.\" No board of nursing is involved — the South Carolina Board of Nursing licenses nurses, not nurse aides. Testing, applications and registry transactions are run by a contractor: \"The South Carolina Department of Health and Human Services (SCDHHS) has contracted with Credentia... Credentia will develop, score, and report the results of the NNAAP® Examination for the South Carolina Nurse Aide Registry. Credentia also processes applications, schedules examinations and administers the examinations.\"",
   "board_url": "https://www.scdhhs.gov/resources/programs-and-initiatives/long-term-living/nursing-facilities/nurse-aide",
   "application_url": "https://credentia.com/test-takers/sc/",
   "renewal_cycle": "Every 24 months, and the qualifying test is paid work rather than education. \"A South Carolina Nurse Aide Certificate is valid for twenty-four (24) months from the date it was issued\" — so the cycle runs from each aide's own issue date, not from a statewide date. To be eligible: \"federal and State regulations require that in the past 24 months, prior to your certification expiration date, you have performed nursing or nursing-related services for pay for at least 8 hours.\" The registry contractor's South Carolina page states the same condition with two extra qualifiers: \"you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay during the previous twenty-four (24) months, under the supervision of an RN or LPN\" — eight consecutive hours in one documented day, and under RN or LPN supervision. Notice: \"Approximately ninety (90) days before the expiration of your certification, Credentia will email you with directions for renewing your certificate. If you have not received a Renewal email, contact 888-204-6249.\" How: through a Credentia Platform account — \"select 'Nurse Aide Registry' in the Resources section and then select 'Submit Continued Enrolment Application'\" — with the $35 re-certification fee paid online. Address and name: \"The South Carolina Nurse Aide Registry must be kept informed of your current address,\" changed through the account's Manage Profile screen; a name or Social Security number change needs a Correction Form with uploaded documentation (marriage certificate, divorce decree or other official document).",
   "ce_hours": "None for re-certification. South Carolina conditions continued enrolment on paid work — at least eight hours of nursing or nursing-related services for pay in the twenty-four months before expiry — and on nothing else. Sources checked, finding no continuing-education or in-service requirement attached to the aide's certification: the SCDHHS Nurse Aide page, the SCDHHS Nurse Aide Training Program Policies document (read in full), and the state-linked South Carolina candidate handbook's Introduction, Eligibility Criteria, Application and Scheduling, Exam Fees, Exam Overview, Quick Reference and The Registry articles. Note what that silence does and does not mean: the twelve hours of annual in-service training that a Medicare- or Medicaid-certified nursing facility must give its aides is a facility duty under federal law, not a condition of the aide's South Carolina certification, and no South Carolina source read states otherwise.",
   "exam": "Two parts, both required, and South Carolina puts a double deadline on them. \"The two parts of the NNAAP Examination process, the Written or Oral Examination and the Skills Evaluation. You must pass both parts in order to be certified and listed on the South Carolina Nurse Aide Registry. You must pass both portions of the exam within two (2) years from your training completion date or within three (3) attempts, whichever comes first, in order to be placed on the South Carolina Nurse Aide Registry. Failure to do so will require completing a 100-hour state-approved Nurse Aide Training Program and retesting both portions of the examination.\" Written: \"seventy (70) multiple choice questions written in English. You will have two (2) hours to complete the Written Examination. You will be told when fifteen (15) minutes remain.\" Oral: available in place of the written test and must be requested on the application — sixty (60) multiple-choice questions, each read twice, plus ten (10) questions testing recognition of common long-term-care words, each word read three times; both parts must be passed. (The handbook describes the oral form two ways in two different articles — its Introduction says the questions are \"provided on an MP3 player\" and that you \"follow along in the test booklet as the questions are read aloud\", while its Exam Overview describes an online proctored option for which \"you will need your own wired headset\". Both are the state-linked handbook's own words; this page reports both and reconciles neither.) skills: \"you will be asked to perform five (5) randomly selected nurse aide skills. You will be given thirty (30) minutes to complete the five (5) skills. You will be rated on these skills by a Nurse Aide Evaluator. You must successfully demonstrate five (5) skills in order to pass the Skills Evaluation.\" The handbook adds a practical warning: \"Please arrive 30 minutes early. Test times are approximate. Please plan to spend the day.\" Where: at a test centre, at an in-facility (INF) event arranged by the candidate's own training programme, or — for the written or oral part only — online with a live remote proctor. Scheduling windows: a test-centre reservation must be made online \"at least two (2) calendar days prior to the test date (not including the test date)\", while \"For Written (or Oral) online exams, you may schedule an exam as early as the following day depending on exam availability.\"",
   "fees": "South Carolina publishes a re-certification fee and very little else. Re-certification: \"Effective July 1, 2020, the fee for re-certification is $35. This fee is non-refundable and non-transferable and must be paid online with a credit card or single-use prepaid card. If you are employed by a Medicaid-certified employer, print the emailed payment receipt and give to your employer for reimbursement\" (South Carolina candidate handbook, The Registry). Examination fees: the amount is not published in the state-linked handbook. Its Exam Fees article says \"The fees listed below have been established for the NNAAP Examination in South Carolina and are effective as of July 1, 2020\" and then carries no fee table at all — the page was checked and contains no dollar figure and no table element. What the article does establish is the payment rule and who owes it: \"Fees are non-refundable and non-transferable once submitted because they cover the administrative costs of registration and testing\"; \"Under federal and South Carolina state laws, candidates employed as nurse aides in nursing homes that participate in Medicaid/Medicare programs are prohibited from paying their examination fees. Employers must pay the examination fee and any retest fee for candidates they employ as nurse aides or candidates who have a written commitment or signed acceptance of employment on file in a Medicaid/Medicare-certified nursing home. Candidates must pay online and be reimbursed by the employer\"; and \"All payments must be made using a credit card or prepaid single-use card.\" Accepted methods elsewhere in the same handbook: \"a credit card or pre-paid credit card (American Express, MasterCard, Visa), ACH/ electronic check, or electronic voucher.\" No separate state application or certification fee is published by SCDHHS — checked across the SCDHHS Nurse Aide page, the SCDHHS Nurse Aide Training Program Policies document and the five handbook articles read — and no reciprocity fee is published either. Training tuition is not set by the state and for many candidates is not owed at all: a programme must notify trainees sponsored by Medicaid-certified nursing facilities \"that they are not responsible for any costs associated with training, including deposits for textbooks and/or supplies used.\"",
   "legal_basis": "[{\"citation\": \"42 C.F.R. Part 483, Subpart D — §§ 483.150 through 483.158 (Requirements That Must Be Met by States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants)\", \"what_it_governs\": \"The federal frame South Carolina's programme runs inside, and the authority SCDHHS names for itself: \\\"The SCDHHS must ensure that the approved Nurse Aide Training Programs and the Nurse Aide Registry is in compliance with the Code of Federal Regulations as stated in 42CFR483.150-158 and with the South Carolina Core Curriculum.\\\" It supplies the state's approval duty and 90-day response deadline (§ 483.151, cited in South Carolina's own programme policy), the programme content and instructor-qualification requirements including the sixteen hours before direct resident contact and the two-years-of-nursing-experience rule for the supervising RN (§ 483.152, also cited in the policy), the competency evaluation (§ 483.154) and the state registry itself (§ 483.156).\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"SCDHHS — Nurse Aide Training Program Policies (Division of Long Term Living; form number shown on the document as 0741-24 0418)\", \"what_it_governs\": \"South Carolina's own operative policy for this credential where no state statute or regulation supplies one: the 100-hour minimum and its 40/20/40 split, programme approval and re-approval, programme director and instructor qualifications, the 1:8 clinical ratio, classroom and skills-lab requirements, the five-year record-retention rule, the contents of programme and student files, and the notice that Medicaid-sponsored trainees owe nothing for training.\", \"url\": \"https://credentia.com/storage/sc/SC-Nurse-Aide-Training-Program-Policies.pdf\"}, {\"citation\": \"S.C. Code Ann. § 40-33-20(63) and § 40-33-42 (Nurse Practice Act — unlicensed assistive personnel and delegation), and § 40-33-30(C) (title protection)\", \"what_it_governs\": \"Not the certification itself, but the scope South Carolina law places around the work a certified nurse aide does: the definition of unlicensed assistive personnel and the bar on administering medications; the nurse's responsibility for delegation and supervision and the requirement that assignable tasks be stated in employer policy; and the rule that a title containing the word \\\"nurse\\\", \\\"such as 'nurse's aide',\\\" must be used in full and never abbreviated to \\\"nurse\\\".\", \"url\": \"https://www.scstatehouse.gov/code/t40c033.php\"}]",
   "exam_vendor": "Credentia, under contract to SCDHHS, administering the National Nurse Aide Assessment Program (NNAAP). The state-linked candidate handbook names the arrangement: \"The South Carolina Department of Health and Human Services (SCDHHS) has contracted with Credentia, a nationally recognized leading provider of assessment services to regulatory agencies and national associations. Credentia will develop, score, and report the results of the NNAAP® Examination for the South Carolina Nurse Aide Registry. Credentia also processes applications, schedules examinations and administers the examinations.\" ⚠ South Carolina's own programme policy still points at the previous vendor, and a reader following it will land in the wrong place: the SCDHHS Nurse Aide Training Program Policies document tells programmes that \"Testing information and training program materials such as the nurse aide training application, classroom supply list, listing of approved training programs, SCDHHS Policy, training presentations, and FAQs may be found on the website at www.pearsonvue.com/sc/nurseaides/.\" The current vendor's own South Carolina page confirms the changeover from the other side, under the heading \"Attention Pearson VUE System Users!\": \"If you previously had an online Pearson VUE account to register for examinations and/or manage your nurse aide registration, you'll need to create a new Credentia Platform online account... When you create a new Credentia Platform account, all of the data from your old Pearson VUE online account will carry over to your new Credentia account.\" This page cites the current vendor and flags the stale pointer rather than repeating it as live guidance. Support numbers published in South Carolina material differ by function and are reported as published: (888) 204-6249 for Credentia registration and scheduling services, (866) 751-5809 for help with the online application, and (800) 475-8290 for questions about re-activating a lapsed certification.",
   "training_hours": "100 hours total, split three ways: 40 classroom, 20 skills practicum, 40 clinical. SCDHHS states it in one sentence in its Nurse Aide Training Program Policies: \"South Carolina requires a minimum of one hundred (100) hours of training. This consists of forty (40) hours of classroom instruction, twenty (20) hours of documented skills practicum, and forty (40) hours of clinical rotation in a nursing home supervised by an approved Registered Nurse.\" That is 25 hours above the federal floor of 75, and the 100-hour figure carries through every South Carolina route — the state-linked candidate handbook requires \"a hundred (100)-hour state-approved nurse aide training program that includes forty (40) hours of clinical training in order to be eligible to test\", and the reciprocity, out-of-state-training and lapsed-certification routes all measure against \"a 100-hour state-approved training program.\" Note the clinical setting is prescribed, not just the hours: the 40 clinical hours must be a \"rotation in a nursing home supervised by an approved Registered Nurse.\" The 16-HOUR pre-clinical rule: South Carolina does not restate it in its own words, but its programme policy requires every student file to contain an \"Affirmation of 16 hours\", and SCDHHS binds its programmes to \"the Code of Federal Regulations as stated in 42CFR483.150-158\", whose 42 C.F.R. § 483.152(b)(1) sets sixteen hours of training before any direct contact with a resident. Programmes must also verify lab-skill competency before clinicals begin: \"Competency with respect to all clinical lab skills is to be verified by the instructor prior to the beginning of the clinical rotation, and a record should be placed in the student's file.\" Time limit on the training, from the state's side: a programme's approval and records regime is set out in the same policy, and student records \"must be maintained on file for a period of five (5) years and/or according to school policy\", including \"a record of attendance for each trainee, the nursing facility sponsor, and the dates and hours of attendance.\"",
   "lapse_rule": "South Carolina publishes three named situations, and which one applies turns on whether you ever completed a 100-hour state-approved programme, not only on how long you have been lapsed. In the state-linked handbook's own words: (1) \"If your nurse aide certification has lapsed on the Registry and you HAVE NOT previously completed a 100-hour state-approved nurse aide training program, you must train at a 100-hour state-approved training program and retest. You must pass both the Written or Oral Examination and the Skills Evaluation before you can be re-activated on the Registry.\" (2) \"If your nurse aide certification has lapsed on the Registry and it has not been expired for more than twenty-four (24) months and you HAVE previously completed a 100-hour state-approved nurse aide training program, you will only be required to retest.\" (3) \"If your nurse aide certification lapsed more than two (2) years ago, you must retrain at a 100-hour state-approved nurse aide training program and retest.\" Route E3 in the eligibility list matches situation (2): it covers applicants who completed a 100-hour South Carolina-approved programme \"AND whose certificate has not been expired for more than twenty-four (24) months. (Certificate must be in good standing.)\" A separate SCDHHS policy statement in the same handbook restates the retrain trigger from the testing side: \"If the CNA (Certified Nursing Assistant) certificate has lapsed and it has been two (2) or more years since the expiration date... The CNA must retrain at a 100-hour State Approved Training program (clinical included).\" Re-activation questions go to a dedicated line: \"For more information about re-activating your nurse aide certification on the Registry, please call (800) 475-8290.\" Not published, and searched for: what happens to an aide with a substantiated abuse, neglect or misappropriation finding — South Carolina's application asks whether the candidate has \"ever been listed on the South Carolina Abuse Registry or any other State's Abuse Registry\" and routes a \"Yes\" to SCDHHS for review, but no South Carolina source read states the consequence, a removal procedure, or a time limit.",
   "reciprocity": "South Carolina calls it reciprocity, runs it as an online application through the registry contractor, and applies a 100-hour floor that turns away aides trained to the federal minimum elsewhere. \"Reciprocity is a process by which a certified nurse aide from another state may qualify for certification in South Carolina because of his or her certification status. You are eligible for reciprocity if you are a nurse aide in a state other than South Carolina in accordance with the competency evaluation requirements of OBRA '87, and if you are currently listed on another state's registry as active and in good standing. A nurse aide must have completed, at a minimum, a 100-hour basic state-approved nurse aide course in order to be placed on the South Carolina Nurse Aide Registry.\" How: \"Nurse aides from out of state who are eligible for reciprocity should complete an online Reciprocity Application,\" submitted through a Credentia Platform account. What comes back: \"When all documents are verified, you will receive your Nurse Aide Registry Certificate and your name will be placed on the South Carolina Nurse Aide Registry, or a denial letter indicating that additional information is required to complete the process.\" Two consequences South Carolina spells out and most states do not: the clock does not reset — \"If you are placed on the South Carolina Nurse Aide Registry, your certification expiration date is retained from the state in which you were originally certified\" — and the old listing survives — \"Once you receive your certification by reciprocity, your name will be on the South Carolina Nurse Aide Registry and the State Registry in which you were originally certified.\" A separate route for someone trained but never registered elsewhere exists and is not reciprocity: eligibility route E2 for a 100-hour out-of-state programme completed within the last twenty-four months, with a certificate or letterhead letter stating classroom and clinical hours. Route E4 covers an out-of-state registry applicant whose certificate \"has not been expired for more than twenty-four (24) months.\" No reciprocity fee and no processing time are published — both searched for.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"South Carolina Department of Health and Human Services — Nurse Aide (the state agency's own page for this credential). Establishes \\\"Per federal regulations, direct care staff employed in a Medicaid certified nursing facility must be listed on the state's Nurse Aide Registry as a Certified Nurse Aide (CNA)\\\", \\\"The primary purpose of the certification program is to ensure that only those nurse aides who have demonstrated competency based upon standardized training and/or testing are employed\\\", \\\"A nurse aide must be certified through the South Carolina Nurse Aide Registry\\\", \\\"The nursing facility must contact the South Carolina Registry to confirm each applicant's status. Possession of a card alone is not an indicator of current certification\\\", the four-month non-certified work allowance, \\\"Any nurse aide candidates seeking certification must attend training at a state-approved program prior to testing\\\", and the programme contact scnar@scdhhs.gov.\", \"url\": \"https://www.scdhhs.gov/resources/programs-and-initiatives/long-term-living/nursing-facilities/nurse-aide\"}, {\"label\": \"SCDHHS — Nurse Aide Training Program Policies (Division of Long Term Living, 7th Floor, PO Box 8206, Columbia SC 29202; scnar@scdhhs.gov). Establishes SCDHHS oversight and the 42 CFR 483.150-158 compliance duty, \\\"South Carolina requires a minimum of one hundred (100) hours of training. This consists of forty (40) hours of classroom instruction, twenty (20) hours of documented skills practicum, and forty (40) hours of clinical rotation in a nursing home supervised by an approved Registered Nurse\\\", the programme-approval requirements and 90-day state response, programme director and instructor qualifications, \\\"The instructor/student ratio must be 1:8 in the clinical area\\\", the five-year student-record rule, the certificate-of-completion hours requirement, the Medicaid-sponsored-trainee cost notice, the student-file list including \\\"Affirmation of 16 hours\\\", and the now-stale pointer to www.pearsonvue.com/sc/nurseaides/.\", \"url\": \"https://credentia.com/storage/sc/SC-Nurse-Aide-Training-Program-Policies.pdf\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Introduction. Establishes the SCDHHS-Credentia contract and its division of duties, the two-part NNAAP structure, \\\"You must pass both portions of the exam within two (2) years from your training completion date or within three (3) attempts, whichever comes first\\\", the 70-question written examination, the 60-plus-10 oral examination delivered on an MP3 player, and the five-skills / thirty-minute skills evaluation rated by a Nurse Aide Evaluator.\", \"url\": \"https://kb-sc.credentia.com/en/article/introduction\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Eligibility Criteria. Establishes the 100-hour / 40-clinical-hour testing prerequisite, the nursing-home sponsorship rule, the light-duty bar on the skills evaluation, the out-of-state training documentation rule, and eligibility routes E1 (South Carolina programme within 24 months), E2 (out-of-state 100-hour programme within 24 months), E3 (lapsed South Carolina certificate not expired more than 24 months), E4 (out-of-state registry certificate not expired more than 24 months) and E5 (student nurse, LPN or RN graduate, or military candidate — contact SCDHHS first).\", \"url\": \"https://kb-sc.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — The Registry. Establishes the change-of-address and change-of-name procedure, \\\"A South Carolina Nurse Aide Certificate is valid for twenty-four (24) months from the date it was issued\\\", the eight-hours-of-paid-work recertification condition, the ninety-day renewal email, \\\"Effective July 1, 2020, the fee for re-certification is $35\\\", the three lapsed-certification situations, the (800) 475-8290 re-activation line, and the reciprocity rules including the 100-hour floor and \\\"your certification expiration date is retained from the state in which you were originally certified.\\\"\", \"url\": \"https://kb-sc.credentia.com/en/article/the-registry\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Exam Overview. Establishes the written examination's seventy questions, two-hour limit and fifteen-minute warning; the oral examination's two parts and the wired-headset requirement for the online proctored form; and the skills evaluation's setting and Nurse Aide Evaluator, with \\\"Please arrive 30 minutes early... Please plan to spend the day.\\\"\", \"url\": \"https://kb-sc.credentia.com/en/article/exam-overview\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Application and Scheduling. Establishes the online-only registration process, the accepted payment methods, the two-calendar-day test-centre booking rule and next-day online-exam availability, the (866) 751-5809 application support line, the SC DHHS two-year / retrain policy including the Fundamentals of Nursing timing rule for RN and LPN students, the two screening questions and their referral to SCDHHS, the accommodations process, and in-facility (INF) testing.\", \"url\": \"https://kb-sc.credentia.com/en/article/application-and-scheduling\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Exam Fees. Establishes that fees \\\"are non-refundable and non-transferable once submitted\\\", that they are \\\"effective as of July 1, 2020\\\", the prohibition on Medicaid/Medicare nursing-home-employed candidates paying their own examination fees and the employer's duty to pay and reimburse, and the credit-card / prepaid-single-use-card payment rule. Recorded also for what it does not contain: no fee table and no dollar figure appear on the page.\", \"url\": \"https://kb-sc.credentia.com/en/article/exam-fees\"}, {\"label\": \"South Carolina Nurse Aide candidate handbook — Quick Reference. Establishes the Credentia registration and scheduling contact details for South Carolina, including \\\"(888) 204-6249\\\" and the service hours, and the list of functions available through a Credentia Platform account.\", \"url\": \"https://kb-sc.credentia.com/en/article/quick-reference\"}, {\"label\": \"Credentia — South Carolina Nurse Aide test-taker page (the registry contractor's South Carolina landing page). Establishes the registration steps, \\\"To conduct a search, you will need the name, city, and date of birth OR registration number of the nurse aide\\\", the renewal condition \\\"you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay during the previous twenty-four (24) months, under the supervision of an RN or LPN\\\", the reciprocity application route, and the \\\"Attention Pearson VUE System Users!\\\" notice describing the migration of accounts from the previous vendor.\", \"url\": \"https://credentia.com/test-takers/sc/\"}, {\"label\": \"South Carolina State Approved Nurse Aide Training Programs 2025 — the official approved-programme list, with each programme's SCDHHS training program code, phone and address, and the note \\\"Training Programs may request to change this information by emailing scnar@scdhhs.gov.\\\"\", \"url\": \"https://credentia.com/storage/sc-training-program-2025.pdf\"}, {\"label\": \"S.C. Code Ann. Title 40, Chapter 33 (Nurses), South Carolina Legislature Online. Establishes § 40-33-20(63)'s definition of unlicensed assistive personnel and the bar on administering medications, § 40-33-42's delegation and supervision rules and the requirement that assignable tasks be stated in employer policies, and § 40-33-30(C)'s title rule for titles containing the word \\\"nurse\\\".\", \"url\": \"https://www.scstatehouse.gov/code/t40c033.php\"}, {\"label\": \"South Carolina General Assembly — H. 3931 of the 125th Session (2023-2024), \\\"Certified Nurse Aides\\\". Recorded as a negative: this bill would have amended § 40-33-42(C) to let a certified nurse aide in a hospital start and cap peripheral intravenous lines and conduct blood draws, and would have defined \\\"certified nurse aide\\\" in the Code. Its status page shows it was introduced 2/9/2023 and \\\"Currently residing in the House Committee on Medical, Military, Public and Municipal Affairs\\\" with no further action — it did not become law, and its definition is not South Carolina law.\", \"url\": \"https://www.scstatehouse.gov/sess125_2023-2024/bills/3931.htm\"}, {\"label\": \"South Carolina Nurse Aide Registry public search (the lookup the registry contractor publishes as \\\"South Carolina Nurse Aide Registry Search\\\").\", \"url\": \"https://cna365.examroom.ai/registry/?StateCode=SC\"}]",
   "page_url": "https://licensingatlas.com/cna/sc-cna/"
  },
  {
   "page_id": "sd-cna",
   "state": "South Dakota",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "South Dakota Board of Nursing — the same board that licenses registered nurses and licensed practical nurses runs the nurse aide credential here. \"The board shall operate the certified nurse aide and medication aide registry\" (ARSD 20:48:16:01). South Dakota is therefore a board-of-nursing state rather than a health-department or Medicaid-agency state, and the Board does more than list people: it approves the training programs, selects the skills to be tested, scores the skills checklists itself, and may contract with a testing agency for the knowledge exam.",
   "board_url": "https://www.sdbon.org/NursingAssistants/Index.asp",
   "application_url": "https://www.sdbon.org/NursingAssistants/Index.asp",
   "renewal_cycle": "Biennial, and — unusually — keyed to the registrant's birth date rather than to the issue date or a statewide date. \"A certified nurse aide registered by the board shall renew the registration biennially. Renewal of registration is by the birth date of the registrant. The board shall send a notice for renewal to the last known address of each registrant at least ninety days before the registrant's expiration date. Failure to receive the notice for renewal does not relieve the registrant of the responsibility for renewing by the final date of the registration renewal period\" (ARSD 20:48:16:14). When you may file: \"An actively registered CNA may renew ninety days or less prior to expiration. CNAs may renew by submitting the online Renewal Application\" (South Dakota Board of Nursing). Two conditions, and South Dakota asks for more than the federal minimum on both. Work: the aide must submit \"evidence of having provided a minimum of twelve hours of nursing or nursing-related services for monetary compensation during the preceding two years\" — twelve hours, not the eight most states use. Education: the aide must also submit \"evidence of having completed a minimum of twelve hours of in-service education annually during the preceding two years which must include content on: (a) Dementia management; and (b) Client abuse, neglect, exploitation, and misappropriation of property, and procedures to report incidents of client abuse, neglect, exploitation, or misappropriation.\" The Board adds a limit on what counts: \"Nursing school courses are not applicable.\" Plus the standing paperwork: apply on the Board's form and submit \"an affidavit that the applicant has committed no act of misconduct as set forth in § 20:48:16:04.\" What happens if either condition fails: \"An applicant who does not meet the requirements in subsections (3) or (4) of this section must pass a board-approved knowledge exam and skills evaluation\" — the same two tests taken for initial registration.",
   "ce_hours": "Twelve hours of in-service education every year — South Dakota is one of the states that does attach a recurring education requirement to the aide's own credential, and it names the content. ARSD 20:48:16:14(4) conditions renewal or reinstatement on \"evidence of having completed a minimum of twelve hours of in-service education annually during the preceding two years which must include content on: (a) Dementia management; and (b) Client abuse, neglect, exploitation, and misappropriation of property, and procedures to report incidents of client abuse, neglect, exploitation, or misappropriation.\" Read the word \"annually\" carefully: it is twelve hours in each of the two years, not twelve hours across the biennium. The Board adds one exclusion in its own words: \"Nursing school courses are not applicable.\" What happens if you cannot show it: the same rule sends you back to the tests — \"An applicant who does not meet the requirements in subsections (3) or (4) of this section must pass a board-approved knowledge exam and skills evaluation.\" Do not confuse this with the other twelve in the same subsection: § 20:48:16:14(3) separately requires \"a minimum of twelve hours of nursing or nursing-related services for monetary compensation during the preceding two years\" — twelve hours of paid work across the two years, alongside twelve hours of education in each year. Two different twelves, two different periods, two different subdivisions. The medication aide number is different again and belongs to a different credential: a registered medication aide renews on \"a minimum of twelve hours\" of medication-administration employment in the preceding twenty-four months (§ 20:48:16:03(3)), with no in-service education condition stated. Sources checked: ARSD article 20:48 in full, SDCL chapter 36-9 in full, and the seven readable South Dakota Board of Nursing nurse aide pages.",
   "exam": "A two-part \"competency assessment program\", and South Dakota's version differs from the national pattern in three ways worth knowing. The rule: \"An applicant, as a requirement for registration as a certified nurse aide, shall pass a board-approved competency assessment program consisting of a knowledge exam, administered by a testing agency in accordance with § 20:48:16:09, and a skills evaluation, administered by a board-approved nurse aide training program, in accordance with §§ 20:48:16:10 and 20:48:16:11. The competency assessment must measure the applicant's knowledge, skills, and abilities on the content listed in § 20:48:18:09\" (ARSD 20:48:16:08) — that is, on the same curriculum the 75-hour programme must teach. (1) the passing score is a number, not a curve: the testing agency must \"Score the exam and require a passing score of seventy-five percent.\" (2) the skills test is four skills, not five, and the Board picks them: the evaluator assesses \"a minimum of four skills selected at random by the board from the pool of skills\", and the completed checklists go to the Board, which \"shall score each checklist to determine if the applicant safely demonstrated the critical items on a checklist.\" (3) retakes are per-component and capped at two: a failing candidate may \"apply to retake the exam two times\" on the knowledge side, and on the skills side the Board \"must provide notice to the applicant of the area not passed and allow the applicant to be re-evaluated on the skill two times\" — re-evaluation is on the skill that was failed, not on the whole test. An oral form is available on request: the testing agency must \"Administer the exam orally upon request by an applicant\", read \"by an approved proctor from a prepared text in a neutral manner.\" The question count, the time limit and the fee are not in the rules — they are in the handbook the Board sends candidates to. Nothing in ARSD article 20:48 or SDCL chapter 36-9 states any of the three; the South Dakota Nurse Aide Candidate Handbook, published by the Board's approved testing vendor and linked by name from the Board's own SD TMU Resources page, states all three: 'The exam consists of eighty (80) multiple-choice questions. The exam will be displayed on a computer screen for you to read, and you will have ninety (90) minutes to complete the exam.' The handbook also publishes the question breakdown behind those eighty questions, in nine subject areas that it says 'align with the South Dakota Board of Nursing's test plan': Aging Process 5; Basic Nursing Skills, Data Collection, and Personal Care 24; Basic Rights 6; Communication and Interpersonal Skills 6; Infection Control 7; Mental Health and Illness 7; Physical Health and Illness 10; Role and Responsibility 8; Safety 7. Its passing score and retake rules match the rule exactly — 'You must obtain a minimum score of 75% to pass the exam' and 'If you do not pass on your first attempt, you can retake the exam two (2) times; if you fail a third time, your instructor will need to provide you with additional instruction.' The edition read here is dated August 14, 2026. The one thing still not published anywhere: a deadline between finishing training and testing. That was searched in ARSD article 20:48 in full, in SDCL chapter 36-9, on the Board's readable nurse aide pages and in the handbook, and none is published in any of them.",
   "fees": "No certified nurse aide fee is published in South Dakota's fee rule, and that negative was searched rather than assumed. ARSD chapter 20:48:06 is titled \"Fees Required of Licensees\" and contains exactly four sections — 20:48:06:01 registered nurse fees, 20:48:06:02 licensed practical nurse fees, 20:48:06:03 certified registered nurse anesthetist fees, and 20:48:06:04 clinical nurse specialist fees. There is no nurse aide or medication aide section, and none of the four mentions an aide. The registration chapter for aides (ARSD 20:48:16) requires an application \"on the form provided by the board\" and never mentions a fee. The Board's statutory fee authority is real but general — SDCL 36-9-21 directs the Board to promulgate rules on \"(6) Fees\" among other subjects, and SDCL 36-9-24 provides that \"All fees received by the board, and money collected under this chapter, shall be deposited in the bank as authorized by the board\", with the Board permitted to require an applicant taking a nationally administered examination \"to remit the portion of the licensing fee covering the cost of examination directly to the organization administering the examination.\" Sources checked, finding no CNA figure: ARSD article 20:48 in full (all chapters, including 20:48:06 and 20:48:16), SDCL chapter 36-9 in full, and the three South Dakota Board of Nursing nurse aide pages that could be read. What is also not published, in the same sources: training tuition (set by each approved programme, not by the Board) and any renewal, reinstatement, endorsement or duplicate-card charge for a nurse aide. This page states no dollar figure for South Dakota rather than importing one. What South Dakota does say about who pays: \"Students employed by a nursing facility cannot be charged a fee for nurse aide training or testing, or new CNAs may be eligible for reimbursement by the nursing facility\" (South Dakota Board of Nursing, Student Initial Registration Requirements). The testing fee is published, but by the vendor, not by the state. The Board directs fee questions to its testing vendor (\"payment of exam fee\"), and the South Dakota Nurse Aide Candidate Handbook that the Board's SD TMU Resources page names sets the amount: \"Fees for the onsite exam, RN remote proctor exam, and Audio version: First Exam: $45; Retake Exam: $45; Audio Exam (first exam and retakes) $45\" — one price for every format, payable by Visa or MasterCard credit or debit card. Who pays depends on your programme: \"Ask your program instructor if you will be self-paying or if your training program has pre-paid your fee.\" Two more vendor charges sit behind that one: arriving late means \"you will not be permitted to take the exam and will forfeit any fees paid without a refund\", and disputing a result costs a \"$25 non-refundable test review request deposit\", which is returned only if the review goes the candidate's way. These are the vendor's prices, set in its handbook rather than in any South Dakota rule, and the state still publishes no fee of its own. The edition read here is dated August 14, 2026.",
   "legal_basis": "[{\"citation\": \"SDCL 36-9-21 (Promulgation of rules) — in particular subdivisions (4), (5) and (6)\", \"what_it_governs\": \"The Board of Nursing's authority over this credential. The Board must promulgate rules on \\\"(4) Except as otherwise provided in § 36-9-28, the delegation of nursing functions to unlicensed assistive personnel under the supervision of a licensed nurse; (5) Except as otherwise provided in § 36-9-28, the training, registration, and supervisory requirements for unlicensed personnel performing delegated nursing functions under the supervision of a licensed nurse; (6) Fees\\\". Every nurse aide rule in ARSD chapter 20:48:16 and 20:48:18 cites § 36-9-21(5) as its law implemented.\", \"url\": \"https://sdlegislature.gov/Statutes/36-9\"}, {\"citation\": \"SDCL 36-9-28 (Practices not prohibited by chapter)\", \"what_it_governs\": \"The fourteen situations the Nurse Practice Act does not reach, including emergency nursing assistance, prelicensure nursing students, gratuitous care of family and friends, care of the sick by domestic servants, housekeepers, companions or household aides who do not assume to practise nursing, religious-tenet care, certain bowel and bladder care outside institutional settings, and personal attendants acting under § 28-8A-10. It is the express exception to the Board's rulemaking power over delegation and over aide training and registration.\", \"url\": \"https://sdlegislature.gov/Statutes/36-9\"}, {\"citation\": \"ARSD chapter 20:48:16 (Certified Nurse Aide and Medication Aide Registry), as amended 52 SDR 24, effective September 8, 2025\", \"what_it_governs\": \"The operative rule for this credential: operation of the registry and its contents (20:48:16:01), grounds for denial or removal (:04), the sixty-day name-change and reporting duties (:05, :06), emergency suspension (:07), the competency assessment program (:08), the knowledge exam and the nine duties of the testing agency including the 75 percent passing score and two retakes (:09), the skills evaluation, its minimum of four board-selected skills and board scoring (:10), skills evaluator qualifications (:11), the five conditions for initial registration and the CNA title protection (:12), registration by endorsement (:13), and biennial birth-date renewal with its twelve-hours-of-work and twelve-hours-of-in-service conditions (:14).\", \"url\": \"https://sdlegislature.gov/Rules/Administrative/20:48\"}, {\"citation\": \"ARSD chapter 20:48:18 (Certified Nurse Aide Training Program), as amended 52 SDR 24, effective September 8, 2025\", \"what_it_governs\": \"Approval of nurse aide training programmes and the 75-hour curriculum: application and the ninety-day approval decision (20:48:18:01), the nine approval requirements including the abuse-screening admission criteria and licensed-nurse supervision (:02), documentation (:03), the clinical facility agreement (:04), program director and primary nurse instructor qualifications and duties (:05 to :07), supplemental personnel (:08), the curriculum requirement of \\\"seventy-five hours of theoretical instruction and supervised practical training\\\" split 16 / 43 / 16 (:09), biennial renewal with a site visit (:10), and withdrawal of approval including the seventy-five percent two-year pass-rate ground (:11).\", \"url\": \"https://sdlegislature.gov/Rules/Administrative/20:48\"}, {\"citation\": \"ARSD chapter 20:48:04.01 (Delegation) — in particular 20:48:04.01:01, :02 and :23\", \"what_it_governs\": \"The general criteria for a licensed nurse delegating a nursing task to a nursing assistant, the supervision conditions, the bar on redelegation, and — in § 20:48:04.01:23 — the rule that in a nursing facility a nurse may delegate only to someone registered as a certified nurse aide or inside the four-month training window.\", \"url\": \"https://sdlegislature.gov/Rules/Administrative/20:48\"}, {\"citation\": \"42 C.F.R. Part 483, Subpart D — §§ 483.150 through 483.158\", \"what_it_governs\": \"The federal frame every state nurse aide registry sits inside, including the 75-hour minimum South Dakota's rule matches exactly, the sixteen hours of training before direct resident contact that South Dakota reproduces in § 20:48:18:09(1), the competency evaluation, and the state registry requirement. South Dakota's own rules do not cite it, so it is recorded here as context rather than as a South Dakota citation.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "South Dakota splits the examination between two administrators, and only one of them is an outside vendor. The knowledge exam — D&S DIVERSIFIED technologies (D&SDT) / Headmaster, LLP, named by the Board in its own words: \"D&S Diversified Technologies (D&SDT) - Headmaster, LLP, is the Board's approved vendor that administers the SD CNA knowledge exam (test). Headmaster's uses a software platform called TMU, which stands for TestMaster Universe. TMU allows nurse aide instructors to register students for the SD CNA knowledge exam. TMU also allows students to update their profiles and view their exam results.\" South Dakota is therefore not an NNAAP state. The registration steps put the instructor in the loop: \"your instructor will assist you to register to take the Board's approved CNA Knowledge Exam through Headmaster's SD TMU... TMU will notify you of your CNA Knowledge exam results. You must get 75% to pass; if needed, you may retake the exam two times.\" The Board splits its own contact lines by subject: \"Contact Headmaster at southdakota@hdmaster.com if you are unable to find answers to your questions on: knowledge testing process, test scheduling, eligibility to test, payment of exam fee... You may also call them Monday through Friday, to Central Time at 800-393-8664. Board of Nursing Contact Information: If you have questions on CNA training programs, skills evaluation process, email sduap@state.sd.us; or call 605-362-2760.\" The rule itself names no vendor — it says only that \"The board may contract with a testing agency to develop and administer a certified nurse aide knowledge exam\" (ARSD 20:48:16:09) and then binds that agency to nine conditions: hold a pool of written questions and use only a portion for any one exam; keep a board-approved policy for selecting and using test proctors; \"Administer the exam orally upon request by an applicant\" with the exam \"read by an approved proctor from a prepared text in a neutral manner\"; tell the applicant beforehand that the Board will be notified of the result; \"Score the exam and require a passing score of seventy-five percent\"; tell a failing applicant which areas were not passed and \"allow the applicant to apply to retake the exam two times\"; safeguard the exam's confidentiality; and report any known or suspected security breach to the Board. The skills evaluation is not run by a vendor at all — it is run by the candidate's own training programme and scored by the Board: \"a board-approved nurse aide training program shall: (1) Use a pool of skills evaluation checklists approved by the board; (2) Use a skills evaluator... to evaluate an applicant's ability to safely demonstrate the performance of a minimum of four skills selected at random by the board from the pool of skills... and (4) Submit the completed skills evaluation checklists to the board for scoring\" (ARSD 20:48:16:10). The evaluator qualification: a skills evaluator \"must: (1) Hold a registered nurse license or privilege to practice in this state; (2) Have a minimum of one year of clinical experience caring for older adults or the chronically ill of any age; and (3) Not be employed as the director of nursing in a nursing facility\" (ARSD 20:48:16:11). The Board's TMU pages also refer candidates to an \"SD Candidate Handbook\" and to a published list of \"Vocabulary Words that are used in the knowledge exam's test items\". The handbook is the South Dakota Nurse Aide Candidate Handbook, published by the vendor at hdmaster.com and dated August 14, 2026; it is the only place the knowledge exam's length, duration and fee appear, and it is quoted in the exam and fees sections of this page alongside the Board page that names it. The handbook points back at the Board for the vocabulary list: \"Review the list of essential words in the document, Vocabulary Words to Study for the Exam, at https://www.sdbon.org/NursingAssistants/SD_TMU_Resources.asp.\"",
   "training_hours": "75 hours, and South Dakota prescribes exactly how they are spent. ARSD 20:48:18:09: \"A nurse aide training program must require students to complete seventy-five hours of theoretical instruction and supervised practical training under the direct supervision of a licensee.\" The rule then splits that total three ways. First 16 hours, before any client contact: the programme must \"Provide an initial sixteen hours of theoretical and skills instruction, prior to a student having direct contact with a client\", on six named topics — communication and interpersonal skills; infection control; safety or emergency procedures, including the Heimlich maneuver; promoting a client's independence; respecting a client's rights; and \"Promoting a client's right to be free from abuse, mistreatment, and neglect and the need to report any instances of such treatment to appropriate facility staff.\" Next 43 hours: \"After the student completes the requirement in subdivision (1), provide forty-three hours of theoretical instruction and supervised practical training in a skills laboratory, a nursing facility, or a comparable nursing practice setting\", across twenty-five listed subjects running from vital signs and skin care through dementia and cognitive-impairment technique to restraint avoidance \"in accordance with current professional standards.\" Final 16 hours: \"Provide sixteen hours of supervised practical training in a nursing facility or a comparable nursing practice setting.\" Sixteen plus forty-three plus sixteen is seventy-five — South Dakota sits exactly at the federal floor of 75 hours rather than above it, but is more prescriptive than most states about the sequence. Supervision during training: a programme must use \"licensed nurses to directly supervise students in the skills laboratory and when performing direct client care\" (ARSD 20:48:18:02(9)). Programme approval: a person or institution must apply to the Board, which \"shall notify the applicant of the approval status within ninety days\", and \"An applicant may not enroll students prior to approval of the program\" (ARSD 20:48:18:01); approval is renewed biennially with an onsite or teleconference visit (ARSD 20:48:18:10). A programme can lose approval for results as well as for process — one withdrawal ground is that \"The program fails to maintain a seventy-five percent pass rate for the students taking the certified nurse aide competency assessment program knowledge exam and skills evaluation from the previous two years.\" A student caught by a withdrawal is protected: they \"may complete that program's training program\" to satisfy the registration requirement.",
   "lapse_rule": "Failing to renew does not remove you from the registry — it changes your status on it. \"If a certified nurse aide fails to renew by the final date of the renewal period or fails to meet the renewal requirements listed in subdivisions (1) to (4), inclusive, of this section, the aide must be listed as lapsed on the registry\" (ARSD 20:48:16:14). Practising on a lapsed registration is a disciplinary ground in its own right: § 20:48:16:04(7) lets the Board deny or remove an aide who has \"Practiced with a lapsed registration.\" Getting back: the rule treats renewal and reinstatement identically — \"The board must renew the registration of, or reinstate the lapsed registration of, a certified nurse aide if the aide\" meets the same four conditions (application, misconduct affidavit, twelve hours of paid nursing or nursing-related services in the preceding two years, and twelve hours of in-service education annually in the preceding two years). So a lapsed aide who can still document the work and the in-service hours reinstates on paperwork alone. An aide who cannot \"must pass a board-approved knowledge exam and skills evaluation, in accordance with §§ 20:48:16:09 to 20:48:16:11, inclusive\" — note that South Dakota does not require the 75-hour programme to be repeated in that situation; the rule names the two tests, not the course. How the Board runs it in practice, in its own words: \"A CNA who's registration has lapsed, or who does not have the required number of employment hours or continuing education, must complete the Lapsed Reinstatement Application, allow 5 business days for the Board to review the application. A lapsed CNA applicant who meets the required employment hours and continuing education will be reinstated to an active CNA registry status. A CNA applicant who does not have the required continuing education and employment hours must retake and pass the CNA knowledge exam and a skills evaluation. The Board will send an email to the CNA with instructions on how to sign up to take the CNA knowledge exam. Upon passing the exam and after the Board receives the four Skills Evaluation Checklist forms, the Board will reinstate the CNA's registry status to active.\" Note the confirmation buried in that last clause — four skills evaluation checklists, matching the rule's \"minimum of four skills\" rather than the five most states use.",
   "reciprocity": "South Dakota calls it registration by endorsement and keeps it short. The rule requires three things and no examination: \"The board shall register an individual seeking registration as a certified nurse aide by endorsement from another state if the individual: (1) Applies on the form provided by the board; (2) Submits an affidavit that the applicant has committed no act of misconduct as set forth in § 20:48:16:04; and (3) Submits evidence of active registration as a certified nurse aide on another state's registry\" — and \"If the applicant does not meet the registration requirements of this section, the board must deny the application\" (ARSD 20:48:16:13). The Board's endorsement page states one condition the rule leaves implicit and one it does not state at all: \"The following must be met to be registered as a CNA in South Dakota by endorsement from another state: Completed a Nurse Aide Training Program (NATP) that was at least 75 hours in length. Actively registered as a CNA on another state's CNA registry. Not have any findings or convictions of abuse, neglect, or misappropriation of property.\" The 75-hour training condition is the one to watch — it is on the Board's page rather than in § 20:48:16:13, and it means an out-of-state programme shorter than the federal floor will not carry across. How: \"complete the CNA Registration by Endorsement online application. Check your application status and print a registration card on the Boards verification website.\" Not published, and searched for in ARSD article 20:48, SDCL chapter 36-9 and the readable Board pages: an endorsement fee, a processing time, and any route for a person trained out of state who was never registered anywhere (the rule's nearest equivalent is the equivalency determination in § 20:48:16:12 for training the Board did not approve, which is an initial-registration route rather than an endorsement one).",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"South Dakota Board of Nursing — Nursing Assistants (the Board's own landing page for this credential family). Paraphrases rather than reproduces the ARSD 20:48:01:01(6) definition of nursing assistant — the page renders it as \\\"a person trained to assist a licensed nurse and function in a supportive role, regardless of title, and to whom a nursing task may be delegated\\\", while the rule itself reads \\\"an unlicensed individual trained to assist a licensed nurse...\\\"; this page quotes the rule, and the divergence is recorded because the word the page drops ('unlicensed') is the one that separates aides from licensees. The page also carries the scope statement \\\"Registration by the board is required for nurse aides who practice in licensed skilled nursing facilities and in some assisted living centers, registered nurse aides use the 'Certified Nurse Aide', abbreviated 'CNA'. Only individuals listed on the registry may use the title of 'CNA'\\\", the summary \\\"Registration requirements include completing a 75-hour board-approved training program, passing a competency evaluation assessment, consisting of a skills evaluation and knowledge exam\\\", the medication aide registration scope and RMA title, and the statements that registration is not required for diabetes aides or dialysis technicians.\", \"url\": \"https://www.sdbon.org/NursingAssistants/Index.asp\"}, {\"label\": \"South Dakota Board of Nursing — Certified Nurse Aide Registration by Endorsement. Establishes the three endorsement conditions in the Board's own words, including \\\"Completed a Nurse Aide Training Program (NATP) that was at least 75 hours in length\\\", and the instruction to \\\"Check your application status and print a registration card on the Boards verification website.\\\"\", \"url\": \"https://www.sdbon.org/NursingAssistants/CNA_Endorsement.asp\"}, {\"label\": \"South Dakota Board of Nursing — Certified Nurse Aide Registration Renewal. Establishes \\\"An actively registered CNA may renew ninety days or less prior to expiration. CNAs may renew by submitting the online Renewal Application\\\", the twelve-hours-of-in-service-annually and twelve-hours-of-paid-nursing-services conditions with their required dementia and abuse-reporting content, the limit \\\"Nursing school courses are not applicable\\\", and \\\"A CNA who has expired or who does not meet renewal requirements must complete the Lapsed or Inactive requirements.\\\"\", \"url\": \"https://www.sdbon.org/NursingAssistants/CNA_Renewal.asp\"}, {\"label\": \"South Dakota Board of Nursing — Certified Nurse Aide Student Initial Registration Requirements. Establishes the Board's own step list (\\\"To be added to the Board's CNA registry, a person must complete a 75-hour Board-approved nurse aide training program (NATP), a skills evaluation, and pass the CNA knowledge exam\\\"), the application-before-training order, the instructor-assisted TMU registration, \\\"You must get 75% to pass; if needed, you may retake the exam two times\\\", \\\"Students employed by a nursing facility cannot be charged a fee for nurse aide training or testing, or new CNAs may be eligible for reimbursement by the nursing facility\\\", the pointer to the Board's CNA Verification website, and \\\"Registration is valid for 2 years.\\\"\", \"url\": \"https://www.sdbon.org/NursingAssistants/CNA_Initial_Requirements.asp\"}, {\"label\": \"South Dakota Board of Nursing — SD TMU Resources. Establishes the testing vendor by name: \\\"D&S Diversified Technologies (D&SDT) - Headmaster, LLP, is the Board's approved vendor that administers the SD CNA knowledge exam (test). Headmaster's uses a software platform called TMU, which stands for TestMaster Universe.\\\" Also establishes what TMU does for instructors and students, the existence of an SD Candidate Handbook and a published vocabulary list for the knowledge exam, the vendor contact (southdakota@hdmaster.com, 800-393-8664) for testing-process and exam-fee questions, and the Board contact (sduap@state.sd.us, 605-362-2760) for training-programme and skills-evaluation questions.\", \"url\": \"https://www.sdbon.org/NursingAssistants/SD_TMU_Resources.asp\"}, {\"label\": \"South Dakota Board of Nursing — Certified Nurse Aide Lapsed or Inactive Registration. Establishes the Lapsed Reinstatement Application and its five-business-day review, that an applicant who meets the employment and continuing-education requirements is reinstated to active status on paperwork, that one who does not \\\"must retake and pass the CNA knowledge exam and a skills evaluation\\\", and that reinstatement follows \\\"after the Board receives the four Skills Evaluation Checklist forms.\\\"\", \"url\": \"https://www.sdbon.org/NursingAssistants/CNA_Reinstatement.asp\"}, {\"label\": \"South Dakota Board of Nursing — Certified Nurse Aide Student Nurses and Inactive Nurses. Establishes the equivalency waiver that lets a nursing student or an inactive nurse \\\"opt out of the 75-hour nurse aide training program (NATP)\\\", the grade-C-or-better fundamentals condition and transcript requirement for students, the RN/LPN license-number condition for inactive nurses, the SDBON Waiver Application and five-business-day review, the TMU upload step, the 75% knowledge-exam pass mark, and \\\"The waiver only applies to nursing students and inactive nurses.\\\"\", \"url\": \"https://www.sdbon.org/NursingAssistants/StudentNurse.asp\"}, {\"label\": \"Administrative Rules of South Dakota, Article 20:48 (Board of Nursing), on the South Dakota Legislature's official site. Establishes the definitions at 20:48:01:01, the delegation rules at 20:48:04.01 including the four-month window at :23, the fee chapter 20:48:06 (which contains no nurse aide fee), the whole certified nurse aide and medication aide registry chapter 20:48:16 as amended effective September 8, 2025, and the certified nurse aide training program chapter 20:48:18 with its 16 / 43 / 16 split of the seventy-five hours.\", \"url\": \"https://sdlegislature.gov/Rules/Administrative/20:48\"}, {\"label\": \"South Dakota Codified Laws chapter 36-9 (Registered and Practical Nurses), on the South Dakota Legislature's official site. Establishes § 36-9-21's rulemaking mandate including subdivisions (4), (5) and (6), § 36-9-24 on the deposit of fees and the direct remittance of a nationally administered examination fee, and § 36-9-28's list of practices the chapter does not prohibit.\", \"url\": \"https://sdlegislature.gov/Statutes/36-9\"}, {\"label\": \"South Dakota Nurse Aide Candidate Handbook (D&S Diversified Technologies / Headmaster LLP, the Board's approved knowledge-exam vendor), edition dated August 14, 2026 — linked by name from the Board's SD TMU Resources page. The only published source for the knowledge exam's structure and price: 'The exam consists of eighty (80) multiple-choice questions... you will have ninety (90) minutes to complete the exam'; the nine subject areas and their question counts (5/24/6/6/7/7/10/8/7 = 80); 'You must obtain a minimum score of 75% to pass the exam'; 'If you do not pass on your first attempt, you can retake the exam two (2) times'; 'First Exam: $45 - Retake Exam: $45 Audio Exam (first exam and retakes) $45'; the forfeit-on-late-arrival policy; and the '$25 non-refundable test review request deposit'. Cited alongside the Board page that names it, and only for testing mechanics and prices.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/SouthDakota/forms/SD_CANDIDATE_HANDBOOK.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/sd-cna/"
  },
  {
   "page_id": "tn-cna",
   "state": "Tennessee",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Tennessee Health Facilities Commission (HFC), Division of Licensure and Regulation — Nurse Aide program and the Tennessee Nurse Aide Registry. The Commission took the nursing-home rules over from the Department of Health: chapter 0720-18 was \"Transferred from chapter 1200-08-06 pursuant to Public Chapter 1119 of 2022 effective July 1, 2022.\" The Commission's mailing address changed in late 2025: \"As of November 24, 2025, we have moved into a single location in Nashville... please direct all mail to our new address: Health Facilities Commission, Andrew Jackson State Building, 502 Deaderick Street, 9th Floor Nashville, Tennessee 37243.\" Registry operation and testing are contracted out — \"As of June 1, 2026, Credentia will be the new Nurse Aide Registry and Testing vendor for the Health Facilities Commission.\"",
   "board_url": "https://www.tn.gov/hfc/division-of-licensure-and-regulation/nurse-aide-information.html",
   "application_url": "https://credentia.com/test-takers/tn/",
   "renewal_cycle": "Every 24 months, and the qualifying test is work rather than education. \"The certification period is for 24 months, and the individual must renew every 2 years by providing verification that they have worked a minimum of eight hours during the 24-month time frame.\" Where the work counts: \"Certified Nurse Aides are required to renew their certification every two years and must provide verification of having worked a minimum of eight hours during the past 24 months in a licensed or certified healthcare facility. (NOTE: Private duty services, sitter, companion services, private physician's offices, etc. are not accepted for renewal.)\" how it is proved — Tennessee is specific: \"This proof of employment must be in the form of either: a pay stub; payroll printout; or notarized attestation form. The pay stub or payroll printout must contain the name of the facility (not the payroll services company), the individual's name, a date and the number of hours worked. The notarized attestation form must be completed and notarized by the facility where the individual worked and must include: the individual's name; social security number; the date the individual worked 8 hours; and the name and title of the individual verifying the information.\" Where it is filed: \"As of June 1, 2026, all Nurse Aide Renewals, and demographic changes will be move to Credentia.com or 1-888-204-6249.\" Notice: the registry contractor \"will send electronic renewal reminders to your email address, as listed on your account, approximately one hundred and twenty (120) days prior to expiration of your enrollment,\" and on success \"you will receive an electronic registry renewal notification by email, which will be valid for the next twenty-four (24) months.\" ⚠ A conflict on the eight hours, recorded both ways and not resolved: the Tennessee candidate handbook says \"you are required to work as a nurse aide A minimum of 8 hours in the previous 24 months in a licensed health care facility. The 8 hours does not have to be consecutive hours,\" while the same contractor's Tennessee test-taker page says \"you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay in an approved facility during the previous twenty-four (24) months.\" Non-consecutive in one place, one documented eight-consecutive-hour day in the other. The Commission's own page requires \"a minimum of eight hours during the past 24 months\" without saying either way, and specifies a proof form that names \"the date the individual worked 8 hours\" — singular. Both published statements are reported here and neither is adopted.",
   "ce_hours": "None for renewal of the certification. Tennessee conditions continued certification on eight hours of qualifying paid work in twenty-four months and on nothing else — no continuing education, no in-service hours, and no course. What Tennessee does require runs to the facility rather than to the aide: \"The facility must complete a performance review of each nurse aide employee at least once every 12 months and must provide regular in-service education based on the outcome of these reviews\" (0720-18-.15(4), headed \"Continued Competency\"). That is a nursing home's duty to its staff, not a condition of the aide's place on the Registry, and no Tennessee source we checked makes it one. An aide assigned to a designated Alzheimer's unit owes a separate forty hours of classroom instruction under 0720-18-.07(10), which is likewise an assignment condition rather than a renewal condition. Sources searched: chapter 0720-18 in full, the Commission's Nurse Aide page, the Commission's Nurse Aide Examination Program FAQ, and the Tennessee candidate handbook's Introduction, Eligibility Criteria, Exam Overview, Exam Fees, Registration and Scheduling, Quick Reference Guide and The Registry articles.",
   "exam": "Two parts — a Knowledge Examination and a Skills Evaluation — and Tennessee's version differs from the standard NNAAP shape in ways worth knowing. Knowledge: \"The Knowledge Examination has seventy-five (75) multiple-choice questions and can be taken both online or in person. You will have two (2) hours to complete the Knowledge Examination. You will be told when fifteen (15) minutes are left to finish.\" Ten of those questions do not count: \"There are ten (10) experimental questions intermingled within the knowledge (oral and written) test... These experimental questions will not be considered/factored into the computation of the final test score.\" Oral: \"The Oral Examination consists of seventy-five (75) multiple-choice questions and is given on a computer for test center exams. Oral exam questions will be read by recorded voice. Each of the seventy-five (75) multiple-choice questions will be repeated as many times as needed. You will have two (2) hours to complete the entire Oral Examination.\" Pass mark: \"You must have a score of 75% or better to pass the knowledge portion of the exam\" — which matches the rule's own floor, \"The minimum passing grade for each test shall be seventy-five percent (75%) for the written or oral component\" (0720-18-.15(1)(a)5). Skills: \"you will be asked to perform five (5) randomly selected nurse aide skills within thirty (30) minutes. You will be rated on these skills by an RN Nurse Aide Evaluator... You must perform all bolded steps correctly and pass all five (5) skills to be successful in the Skills Evaluation.\" The rule describes the same test from the regulator's side and adds how the five are drawn: \"The performance demonstration portion of the test shall consist, at minimum, of five performance tasks, which shall be selected randomly for each registrant from a pool of skills evaluation tasks ranked according to degree of difficulty, with at least one task selected from each degree of difficulty. Registrants are required to pass a minimum of five (5) performance tasks.\" Question pool: the rule caps the graded test — \"The test will be developed from a pool of questions, only a portion of which is to be used for grading purposes in any one test, not to exceed one hundred (100) questions.\" Evaluators: \"Evaluators must maintain an active RN license and have one year experience caring for the elderly or critically ill.\" Where: at a Regional Testing Site (RTS), which \"may provide testing to eligible candidates from across Tennessee\"; at an In-Facility (INF) site \"associated with an approved training program or facility\" serving its own students or employees; or online with a live proctor for the knowledge or oral exam. Booking windows: \"For exams at test center locations, you must make an online reservation via a PC... at least ten (10) calendar days prior to the test date\", while \"For Written (or Oral) online exams, you may schedule an exam as early as the following day depending on exam availability.\" A one-month deadline survives in the rule and sits oddly with the online system, and is recorded rather than reconciled: \"Applications to take the test shall be sent by the program coordinator to the appropriate testing agency postmarked no later than thirty (30) days prior to the test date\" (0720-18-.15(1)(b)). Arrival: \"arrive 30 min early to complete the required check-in process. Late arrivals may not be permitted to test.\"",
   "fees": "Examination fees, as published for Tennessee: Knowledge Exam at a test center $35; Knowledge Exam online $35; Oral Exam English online $35; Oral Exam Spanish online $35; Skills Exam at a test center $87. \"You must pay for both the Skills Evaluation and the Written (or Oral) Examination at the time of scheduling\", payment \"in the form of a credit card, debit card, ACH (electronic check), or electronic voucher\", and \"Fees are not refundable.\" Who actually pays — usually not the candidate: \"Under Federal and Tennessee laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to re-test. For individuals associated with these training programs you will have no testing fee.\" The Commission says the same about training: \"training and testing are free for candidates who train in a nursing home based program and are employed by a skilled nursing facility.\" If you paid your own way and are hired within a year, the facility owes you the money back, in halves: \"An individual who does not have an employment relationship with a facility at the time the individual enters a NATCEP or CEP, but becomes employed, or obtains an offer of employment within twelve (12) months of completing the program, will be reimbursed for the costs of training and testing by the facility that employs or offers employment to this individual. This reimbursement will be made on a pro rata basis... The nurse aide will be reimbursed for half the costs of training and testing after the nurse aide has worked at the facility as a nurse aide for one hundred thirty (130) hours and the remaining half of the training and testing costs after the nurse aide has worked an additional one hundred thirty (130) hours. The hours start accruing when the individual has successfully tested and is listed on the registry.\" Not published, and searched for across chapter 0720-18 in full, the Commission's Nurse Aide page, the Commission's Nurse Aide Examination Program FAQ and the Tennessee candidate handbook articles read: a state application or certification fee; a renewal fee; a reciprocity fee; and any state-set training tuition (\"Fees, length of study and other requirements may vary by program\" for a private, non-nursing-home programme).",
   "legal_basis": "[{\"citation\": \"Rules of the Tennessee Health Facilities Commission, Chapter 0720-18 (Standards for Nursing Homes), March 2026 revision — in particular 0720-18-.15 (Nurse Aide Training and Competency Evaluation), 0720-18-.01(9) and (44)-(45) (definitions), and 0720-18-.07(10) (Alzheimer's units)\", \"what_it_governs\": \"The whole Tennessee nurse aide apparatus: the definition of a certified nurse aide, the incorporation of the federal OBRA-87 training and competency regulations, the testing service's duties including the thirty-mile test-site rule and the 75 percent passing grade, the five-performance-task skills test and its difficulty-ranked pool, the three-consecutive-failures retraining trigger, training programme approval and its 70 percent pass-rate condition, the 25:1 and 15:1 student-to-teacher ratios, the reference to \\\"the seventy-five (75) hour training program\\\", the Nurse Aide Registry's required contents and the four-month facility rule, the twenty-four-month removal rule, and the facility's annual performance review and in-service duty. Authority as printed in the chapter: \\\"T.C.A. §§ 4-5-202, 4-5-204, 68-11-202, 68-11-204, 68-11-206, 68-11-207, 68-11-209, 68-11-210, 68-11-211, 68-11-213, and 68-11-804 and Public Chapter 148 of 2021.\\\" Administrative history: original rule filed September 4, 2003, effective November 18, 2003; amended effective June 25, 2015; \\\"Transferred from chapter 1200-08-06 pursuant to Public Chapter 1119 of 2022 effective July 1, 2022.\\\"\", \"url\": \"https://publications.tnsosfiles.com/rules/0720/0720-18.20260318.pdf\"}, {\"citation\": \"42 C.F.R. Part 483, Subpart D — §§ 483.150 through 483.158, incorporated by Tennessee at 0720-18-.15\", \"what_it_governs\": \"The federal requirements Tennessee adopts wholesale: \\\"All nurse aide training programs must comply with the federal nurse aide training and competency regulations, promulgated pursuant to the Omnibus Budget Reconciliation Act of 1987.\\\" That is where Tennessee's 75-hour minimum, the sixteen hours before direct resident contact, the competency evaluation and the state registry requirement actually live — Tennessee's own chapter states no hours table of its own.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP), under contract to the Health Facilities Commission — and it is new. The Commission announces the change at the top of its own nurse aide page: \"As of June 1, 2026, Credentia will be the new Nurse Aide Registry and Testing vendor for the Health Facilities Commission. A list of Credentia's publicly available test events may be found at Cna365.examroom.ai/gis/public-events. To learn more about Credentia, please visit their website at www.Credentia.com.\" The same notice adds that \"The Tennessee Nurse Aide Handbook is available on the Credentia website and on the Health Facilities Commission Nurse Aide website.\" The transition is still in progress and Tennessee says so, which matters for anyone trying to book a test: the Commission's own Nurse Aide Examination Program FAQ answers \"Why can't I find an exam appointment near me?\" with \"Testing availability is expanding as additional testing sites and Nurse Aide Evaluators are brought into the program,\" tells candidates to \"check the schedule frequently,\" and states that \"Credentia and HFC are working to expand statewide testing capacity. Additional locations and evaluators are being added as they complete the required approval, training, and certification processes.\" It also warns that the test itself has changed: candidates \"should review the current Tennessee candidate handbook for specific eligibility and examination requirements including the skill steps which will differ from the previous vendor.\" The previous vendor is not named by either Tennessee or the current vendor — the vendor's Tennessee page says only \"Attention Previous Testing Vendor Users! If you previously had an online account with a previous testing vendor to register for examinations, you'll need to create a new Credentia Platform online account... all of the data from your previous testing vendor account will carry over.\" This page names no earlier vendor. What the rule requires of whoever holds the contract (0720-18-.15(1)(a)): annual publication of testing schedules and sites; test sites placed \"so that no individual is required to drive farther than thirty (30) miles to reach a test site\"; scheduled tests administered except where nobody is booked; publication of the numbers passing and failing after each test; and a minimum passing grade of 75 percent on the written or oral component. Contact numbers as published: Credentia 1-888-204-6249; HFC 615.532.5171.",
   "training_hours": "75 hours — the federal floor — and Tennessee reaches that figure by incorporating the federal rule rather than by writing its own hours table. The rule opens: \"All nurse aide training programs must comply with the federal nurse aide training and competency regulations, promulgated pursuant to the Omnibus Budget Reconciliation Act of 1987, and with federal labor laws, including but not limited to minimum age requirements. Copies of these regulations may be obtained from the department\" (0720-18-.15). Tennessee's own text does name the number, once, in the supervision paragraph: a programme instructor \"must be present or readily available on-site during all clinical training hours including direct patient care for the seventy-five (75) hour training program\" (0720-18-.15(2)(d)3). What Tennessee does not publish, and this page therefore does not state: any classroom-versus-clinical split of those 75 hours. The rule instead makes the split a programme-by-programme matter — an application for approval must contain a \"Description of course content specifying the number of hours to be spent in the classroom and in clinical settings\" (0720-18-.15(2)(a)4), which is a disclosure requirement, not a minimum. Sources checked for a Tennessee-stated classroom/clinical minimum and not found: chapter 0720-18 in full (including 0720-18-.01 definitions, 0720-18-.06 basic services, 0720-18-.07 Alzheimer's units and 0720-18-.15 in full), the Commission's Nurse Aide page, and the Commission's Nurse Aide Examination Program FAQ. The sixteen hours of training required before any direct resident contact come from the federal rule Tennessee incorporates (42 C.F.R. § 483.152(b)(1)); Tennessee's own equivalent is a subject-order rule rather than an hours rule — \"All activities of daily living (ADL) skills... must be taught prior to student performing direct patient care.\" An extra 40 hours applies to an aide assigned to a designated Alzheimer's unit (0720-18-.07(10)), on top of the training programme.",
   "lapse_rule": "Twenty-four consecutive months without paid nursing-related work ends the certification, and Tennessee applies the federal rule directly: \"Under federal requirements, enrollment on the Registry is no longer valid for any individual who has had a lapse of twenty-four (24) consecutive months or more in the performance of paid nursing-related services.\" The rule states the consequence on the registry itself: \"The name of any individual who has not performed nursing or nursing related services for a period of twenty-four (24) consecutive months shall be removed from the Nurse Aide Registry\" (0720-18-.15(3)(b)). Getting back on — reinstatement is heavier than renewal, and the Commission says so: \"If the certification expires, the individual must then reinstate their certification which requires more documentation than a renewal. Proof of eight hours worked each year is required for each year beginning the year prior to the expiration year and continuing through the current year. If continuous employment providing CNA duties in a certified facility cannot be provided, the individual must retrain and retest in order to be reactivated.\" So the reinstatement standard is eight hours in each year across that span, not eight hours across the whole period. The registry contractor describes the same step from its side: \"As a formerly active member of the Registry, you will need to complete a reinstatement application. You may not be employed as a nurse aide until you have official notification of a reinstated active status.\" A practical warning Tennessee publishes for transfers: \"If you have ever been previously certified in Tennessee, you should contact the Registry to determine whether you are eligible to reinstate prior to completing the reciprocity application.\"",
   "reciprocity": "Tennessee accepts reciprocity from every state but one. \"An individual who is currently listed as active with no derogatory or abuse information on another State's list of certified individuals can apply for reciprocity. Tennessee accepts reciprocity from all States except Florida. An individual living in Florida must retrain and retest in Tennessee in order to become certified as a CNA in this State.\" The candidate handbook repeats the exclusion: \"Florida Nurse aide certifications are not accepted for reciprocity in the state of Tennessee.\" How it works: \"Individuals who are certified in other states may request to have their certification added to Tennessee. This individual must have an active certification in the state they wish to transfer from with no abuse or other derogatory information listed. Reciprocity applications are currently being processed by Tennessee's state testing agency. The application is online at www.credentia.com. Select Tennessee from the list of States. Upon receipt of all required information, the process typically takes no longer than one week.\" What the registry contractor checks on eligibility route E3: \"Testing is not required. The applicant will create an account and submit their E3 application into the Credentia platform and upload all requested documents. Credentia will verify certification in each state the applicant names on their application, check the abuse registry in the listed states including Tennessee.\" Two consequences Tennessee spells out: a previously-Tennessee-certified applicant should ask about reinstatement first — \"If you have ever been previously certified in Tennessee, you should contact the Registry to determine whether you are eligible to reinstate prior to completing the reciprocity application\" — and holding several states at once is fine but not free of admin: \"Certification can be held in numerous states; however, renewal will be separate for each state.\" Verification out of Tennessee is self-service only: \"Effective May, 2019, all states agencies have been advised that Tennessee no longer manually completes paper verification forms. Anyone who has ever been certified in Tennessee can be located on the website.\"",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Tennessee Health Facilities Commission — Tennessee Nurse Aide Programs and Registry (the Commission's own page for this credential). Establishes the June 1, 2026 vendor change and the public-events link, the OBRA-87 framing and the sentence naming the Department of Health as the approving agency, \\\"NOTE: that all laws and regulations that govern the Tennessee Nurse Aide Registry are under nursing home requirements\\\", the training-programme access process, the approved-programme list link, \\\"training and testing are free for candidates who train in a nursing home based program and are employed by a skilled nursing facility\\\", the certification requirement \\\"within 24 months from completion of the class\\\", the LPN/RN transcript and military DD-214 challenge routes, \\\"Tennessee accepts reciprocity from all States except Florida\\\", the 24-month certification period and eight-hour renewal condition, the reinstatement standard of eight hours each year, the accepted proof-of-employment forms, the name- and address-change duty, \\\"Effective May, 2019... Tennessee no longer manually completes paper verification forms\\\", the November 24, 2025 office move and new mailing address, and the Credentia and HFC contact numbers.\", \"url\": \"https://www.tn.gov/hfc/division-of-licensure-and-regulation/nurse-aide-information.html\"}, {\"label\": \"Rules of the Tennessee Health Facilities Commission, Chapter 0720-18 (Standards for Nursing Homes), March 2026 (Revised), Tennessee Secretary of State official compilation. Establishes 0720-18-.01(9)'s definition of Certified Nurse Aide or Certified Nursing Assistant, 0720-18-.07(10)'s extra forty hours of classroom instruction for aides on an Alzheimer's unit, and all of 0720-18-.15 including the federal-compliance opener, the testing-service duties, the 75 percent passing grade, the five-task skills test, the three-consecutive-failures rule, the thirty-day application postmark rule, the 100-question grading cap, the Nurse Aide Advisory Committee, programme approval and the 70 percent pass-rate escalation, \\\"the seventy-five (75) hour training program\\\", the ADL-before-direct-care rule, the 25:1 and 15:1 ratios, the Registry's contents, the four-month facility rule, the twenty-four-month removal rule, and the Continued Competency provision.\", \"url\": \"https://publications.tnsosfiles.com/rules/0720/0720-18.20260318.pdf\"}, {\"label\": \"Tennessee Health Facilities Commission — Tennessee Nurse Aide Examination Program Frequently Asked Questions (PDF published by the Commission). Establishes the state of the testing transition (\\\"Testing availability is expanding as additional testing sites and Nurse Aide Evaluators are brought into the program\\\"), the RTS and INF site definitions, the evaluator qualifications (\\\"active RN license and have one year experience caring for the elderly or critically ill\\\"), \\\"Candidates are provided with three attempts to take the examination within a two year period following the completion of training\\\", the warning that the skill steps \\\"will differ from the previous vendor\\\", the thirty-minute early arrival rule, and the Candidate Services number 1-888-204-6249.\", \"url\": \"https://www.tn.gov/content/dam/tn/hfc/documents/Tennessee%20Nurse%20Aide%20Examination%20Program%20FAQ.pdf\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — Exam Overview (the handbook the Commission links from its own nurse aide page). Establishes the 75-question two-hour Knowledge Examination and its ten ungraded experimental questions, the 75-question Oral Examination read by recorded voice and repeatable as many times as needed, \\\"You must have a score of 75% or better to pass the knowledge portion of the exam\\\", and the five-skills / thirty-minute Skills Evaluation rated by an RN Nurse Aide Evaluator with all bolded steps required.\", \"url\": \"https://kb-tn.credentia.com/en/article/exam-overview\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — Eligibility Criteria. Establishes routes E1 (Tennessee-approved training within the last 24 months), E2 (Challenge Application) and E3 (Reciprocity Application, no testing required), the three-attempts-each limit for skills and knowledge, the retrain trigger, the state-approval step for challenge documents, and \\\"Tennessee does not accept Florida issued nurse aide certifications for reciprocity.\\\"\", \"url\": \"https://kb-tn.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — Exam Fees. Establishes the Tennessee fee table (Knowledge Exam test center $35, Knowledge Exam online $35, Oral Exam English online $35, Oral Exam Spanish online $35, Skills Exam test center $87), \\\"You must pay for both the Skills Evaluation and the Written (or Oral) Examination at the time of scheduling\\\", the accepted payment forms, \\\"Fees are not refundable\\\", the nursing-home payment obligation, and the full 130-hour / 130-hour pro rata reimbursement rule with its twelve-month employment window.\", \"url\": \"https://kb-tn.credentia.com/en/article/exam-fees\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — The Registry. Establishes the 120-day electronic renewal reminder, the eight-hours-in-24-months renewal condition with \\\"The 8 hours does not have to be consecutive hours\\\", the 24-month validity of a renewed enrollment, the change of address / name / SSN procedure, the federal 24-month lapse rule and the reinstatement application, \\\"You may not be employed as a nurse aide until you have official notification of a reinstated active status\\\", and the reciprocity rules including the Florida exclusion.\", \"url\": \"https://kb-tn.credentia.com/en/article/the-registry\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — Registration and Scheduling. Establishes that new training-programme graduates do not create their own applications (\\\"The training program will upload your information, and you will receive an email to log in and verify your information\\\"), the payment forms, the ten-calendar-day test-centre booking rule, and next-day availability for online written or oral exams.\", \"url\": \"https://kb-tn.credentia.com/en/article/registration-and-scheduling\"}, {\"label\": \"Tennessee Nurse Aide candidate handbook — Quick Reference Guide. Establishes the Credentia customer service contact and hours for Tennessee and the list of functions available from the candidate account, including submitting a change of name or address, completing a renewal or reciprocity application, scheduling an exam and viewing a score report.\", \"url\": \"https://kb-tn.credentia.com/en/article/quick-reference-guide\"}, {\"label\": \"Credentia — Tennessee Nurse Aide test-taker page (the registry and testing contractor's Tennessee landing page, linked by the Commission). Establishes the registration steps for Tennessee, \\\"To conduct a search, you will need the name, city, and date of birth OR registration number of the nurse aide\\\", the renewal statement \\\"you are required to work as a nurse aide at least one documented day (eight consecutive hours) for pay in an approved facility during the previous twenty-four (24) months\\\", the reciprocity application route, and the \\\"Attention Previous Testing Vendor Users!\\\" account-migration notice.\", \"url\": \"https://credentia.com/test-takers/tn/\"}, {\"label\": \"Tennessee Nurse Aide Registry public search (the lookup the registry contractor publishes as \\\"TN Nurse Aide Registry Search\\\").\", \"url\": \"https://cna365.examroom.ai/registry/?StateCode=TN\"}]",
   "page_url": "https://licensingatlas.com/cna/tn-cna/"
  },
  {
   "page_id": "tx-cna",
   "state": "Texas",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Texas Health and Human Services Commission (HHSC) — Long-term Care Regulation, Credentialing Branch (Nurse Aide Registry)",
   "board_url": "https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry",
   "application_url": "https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/become-a-certified-nurse-aide-texas",
   "renewal_cycle": "Every 24 months, and it is renewed on work, not on a fee. HHSC's FAQ: 'Once I am certified, how often do I have to renew? You must contact the Nurse Aide Registry and verify your employment at least every two years to remain in active status.' Renewal may be filed 'beginning three months prior to the expiration date on the certificate.' Two ordinary routes exist: the nurse aide files a Certified Nurse Aide Renewal Application in TULIP with a completed Employment Verification (Form 5506-NAR), or the employer files a Nurse Aide Facility Staff Renewal on the aide's behalf and acknowledges both the employment and the in-service education. Either way the aide (or the employer) must confirm no Employee Misconduct Registry entries and no disqualifying criminal convictions. A fifth route exists for military applicants: 'This application applies to military service member, military veteran, or military spouse applicants who are certified and hold an Active or Expired CNA certificate in Texas. They must complete 24 hours of continuing education. These applications are prioritized.' Separately, a military spouse stationed in Texas who holds an active certificate in another state can be issued a Texas certificate 'for three years, as long as the applicant maintains active status in the other state' — a three-year term rather than two, and the applicant chooses between that waiver and ordinary reciprocity. Name changes and address changes are filed in TULIP and are not part of renewal.",
   "ce_hours": "24 hours of in-service education every two years, with mandated dementia content. HHSC quotes the rule verbatim on its Nurse Aide In-Service Education page: 'Effective September 1, 2013, a nurse aide renewing a certification must complete at least 24 hours of in-service education every two years that includes training in geriatrics and the care of residents with a dementia disorder, including Alzheimer's disease' (26 TAC 556.9). The same sentence is repeated on the renewal page for every renewal route. Where the hours can come from: 'requirements can be fulfilled through a nursing facility or an approved Nurse Aide Training and Competency Evaluation Program', and 'All approved NATCEPs are eligible to offer in-service education.' HHSC also publishes free computer-based in-service modules of its own — a six-module set (Texas Long-term Care Overview, Resident Rights, Quality of Resident Care, Infection and Infection Control, Dementia Disorders, Resident Care for Dementia-related Conditions) where 'Each course satisfies 2 hours toward the 2-year requirement of 24 hours' and 'CNAs get 2 hours of credit for each course, as long as they score a minimum of 70% and have a copy of the learning certificate' — plus a separate five-module Infection Control for Nurse Aides series that HHSC describes as satisfying an annual in-service requirement. The aide keeps the certificates: 'To document successful course completion, participants must print a copy of the course certificate available at the end of the training and keep the certificate for documentation purposes.' The state's free 60-hour classroom CBT for new trainees does not count: 'The course will not satisfy the 24 hours of in-service education and is only for those interested in becoming a certified nurse aide.'",
   "exam": "Two exams, both required: a Clinical Skills test and a Written test (which may instead be taken in Oral form). Clinical skills — 'The Clinical Skills test is a timed test. You will be scored on five skills. While performing three assigned skills, you will also be scored on two additional skills - Handwashing and Indirect Care.' Indirect Care covers resident rights, communication with the resident, resident safety and comfort, and infection control. 'To pass the Clinical Skills test, you must pass all five skills.' Each test form carries its own time limit depending on the skill combination, stated on the instruction card. The test runs in a clinical laboratory 'with someone acting as a resident or with a mannequin', and the exact checklist the evaluator uses is published in advance. Written — 'The Written Test consists of 60 multiple-choice questions... You will have 90 minutes to take the test.' Oral — the written test may be taken orally, with questions read aloud and replayable; 'All candidates testing by way of Oral Exam are required to also pass a Reading Comprehension exam.' Language — 'The Texas Nurse Aide Clinical Skills Exam is offered in English only, however, the Competency Exam is offered in English and Spanish. Translators are not permitted, and translation dictionaries may not be used.' Both tests 'are written so as not to exceed a sixth-grade reading level, as required by the Texas Competency Evaluation Program.' Attempts — HHSC: 'People who fail either the skills or the written/oral examination may re-test twice. People who don't pass after three attempts must go through the training again before being allowed to take the test again.' The candidate bulletin states the same limit and adds the deadline: 'Pass the Clinical Skills exam and Written or Oral exam within 24 months of completing your training.' Delivery — written/oral exams are offered at computer-based testing centres, regional testing sites, in-facility testing sites, and by live remote proctoring; clinical skills exams are offered only at regional testing sites and in-facility testing sites. These exam details come from the Texas CNA Candidate Information Bulletin published by Prometric on the page HHSC itself links; the attempt limit is corroborated independently by HHSC's own FAQ.",
   "fees": "No state certification fee is published. Not one dollar figure for applying for, issuing or renewing a Texas nurse aide certificate appears on HHSC's Nurse Aide Registry page, its Become a Certified Nurse Aide page, its Renew or Make Changes page, its NAR Credentialing FAQs, its NATCEP page or its In-Service Education page — all six checked. What a candidate actually pays: Exam fees, paid to Prometric at scheduling by credit card or voucher — Written Test $31; Oral Test $41 ('Oral includes Reading Comprehension Exam'); Clinical Skills Test $89 — the same schedule applying to 'Newly Trained, Lapsed, or Re-tester' candidates. 'Testing fees are nonrefundable and nontransferable.' Rescheduling — '$25 fee if you reschedule 5-29 days before your test. If you reschedule less than 5 days before your test you will lose your test fee and be considered a no show... There is no charge for rescheduling 30 or more days before your appointment.' A no-show or late arrival costs the full exam fee again; a state-side cancellation for weather or a major incident is rescheduled 'without additional cost'. DPS criminal history check — required on every route except the standard train-then-test route; HHSC says only 'There is a fee for each check' and does not publish the amount, and the amount is not stated on any HHSC nurse aide page read. Training cost — set by whichever approved NATCEP the trainee uses and not published by HHSC; the state's own 60-hour classroom CBT is explicitly free.",
   "legal_basis": "[{\"citation\": \"26 Texas Administrative Code, Part 1, Chapter 556 (Nurse Aides) — HHSC's nurse aide rules, comprising 556.1 Basis; 556.2 Definitions; 556.3 NATCEP Requirements; 556.4 Filing and Processing an Application for a NATCEP; 556.5 Program Director, Program Instructor, Supplemental Trainers, and Skills Examiner Requirements; 556.6 Competency Evaluation Requirements; 556.7 Review and Reapproval of a NATCEP; 556.8 Withdrawal of Approval of a NATCEP; 556.9 Certificate of Registration, Nurse Aide Registry, and Renewal; 556.10 Certification of Individuals with Criminal Convictions in Their Backgrounds; 556.11 Expiration of the Certificate of Registration and Active Status; 556.12 Waiver, Reciprocity, and Exemption Requirements; 556.13 Findings and Inquiries; 556.14 Alternate Licensing Requirements for Military Service Personnel. This is the URL HHSC itself links from its NAR Statutes and Rules page. The section text could not be read; nothing on this page is quoted from the rule except the one sentence of 556.9 that HHSC reproduces verbatim on its own In-Service Education page.\", \"url\": \"https://texas-sos.appianportalsgov.com/rules-and-meetings?chapter=556&interface=VIEW_TAC&part=1&title=26\"}, {\"citation\": \"Texas Health and Safety Code, Title 4, Chapter 250 (Nurse Aide Registry and Criminal History Checks of Employees and Applicants for Employment in Certain Facilities Serving the Elderly or Persons with Disabilities) — the statute behind the registry and the criminal-history bar; HHSC cites 250.006 specifically as the source of the disqualifying convictions. Linked by HHSC from its NAR Statutes and Rules page. Text not readable.\", \"url\": \"https://statutes.capitol.texas.gov/Docs/HS/htm/HS.250.htm\"}, {\"citation\": \"42 C.F.R. 483.156 (federal nurse aide registry rule), as applied by HHSC\", \"what_it_governs\": \"The permanence of registry findings. HHSC: 'according to federal regulation at 42 Code of Federal Regulation, §483.156, findings of abuse, neglect and misappropriation of resident property must remain on the registry permanently', with a petition available after one year for a finding of neglect only. Cited by HHSC; the federal text itself was not read for this page.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/nar-credentialing-faqs\"}, {\"citation\": \"42 C.F.R. 483.151 (federal NATCEP rule), as applied by HHSC\", \"what_it_governs\": \"The federal standard HHSC surveys Texas training programs against. HHSC's Provider Letter 2023-16 announced that from October 1, 2023 its Licensing and Credentialing division 'will be performing regular surveys on NATCEPs to ensure compliance with the NATCEP federal regulations at 42 CFR §484.151 and state rules at 26 TAC §556.' Note the agency's own typo: the letter as summarised on the HHSC page cites '42 CFR §484.151', which is a home health agency part; the nurse aide training regulation is 42 C.F.R. 483.151. Recorded as written and flagged rather than silently corrected. The federal text was not read for this page.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-training-competency-evaluation-program-natcep\"}]",
   "exam_vendor": "Prometric, under contract to HHSC. The state's own words: 'HHSC is contracted with Prometric to develop, score and report the results of the Nurse Aide Examination required for certification.' HHSC links Prometric's Texas Nurse Aide page directly and gives its contact details (1-800-488-5787, txcna@prometric.com, Monday–Friday 7 a.m. to 5 p.m. Central). Exam results flow back into HHSC's system automatically: 'Exam scores are electronically sent to TULIP from the Prometric system.' Note that HHSC — not Prometric — approves ADA testing accommodations.",
   "training_hours": "100 clock hours minimum, split 60/40 by the state. HHSC's NATCEP requirements page: 'Each NATCEP must provide a minimum of 100 clock hours of training, including: 60 clock hours of classroom training that doesn't involve direct resident care; 40 clock hours of hands-on resident care in a nursing facility.' HHSC repeats the same split on the candidate-facing pages — 'a state-approved nurse aide training program (60 hours of classroom and 40 hours of clinical)'. A third number sits inside the 60: 'At least 16 introductory hours of training in the following areas before direct client contact: Communication and interpersonal skills; Infection control; Safety and emergency procedures, including the Heimlich maneuver; Promoting residents' independence; Respecting residents' rights', with the remainder of the HHS-established curriculum covering personal care skills, basic nursing skills, mental health and social service needs, care of cognitively impaired residents, basic restorative services and residents' rights. The 60 classroom hours can be done free and online through the state itself: 'HHSC has created a Computer Based Training (CBT) that nurse aide trainees can use to complete the 60-hour classroom training online... Once a trainee finishes the CBT, they must complete the 40-hour clinical portion of the training with an approved NATCEP to qualify to take the CNA exam.' HHSC adds that 'The CBT course is a free course. Anyone attempting to charge for this course or completing the course for someone else will be referred to HHSC Office of Inspector General.' The CBT is pass/fail with a certificate of completion and no final grade, and it does not count toward the 24 in-service hours. Texas therefore sits 25 hours above the federal 75-hour floor. The rule behind these figures is 26 TAC ch. 556 (see the legal-basis details on this page); the hours are quoted here from HHSC's own program-requirements pages because the administrative code text itself could not be read.",
   "lapse_rule": "Status goes to Expired when the two-year work-and-training test is not met, and getting back on the registry means testing again. HHSC's own status definition: 'Expired – The nurse aide's registration is expired. To renew registry status, the nurse aide must provide verification of qualifying employment. If the person is unable to verify employment, he or she will have to re-train and/or re-test. The nurse aide is currently not employable as a nurse aide in a licensed nursing facility in the state of Texas.' The candidate bulletin states the trigger precisely: 'If you have NOT performed nursing or nursing related duties in a health care setting and completed 24 hours of in-service education during the twenty-four (24) months since registration or renewal, your nurse aide registration has expired. To renew your registration, you must take the skills and written or oral examinations.' Two re-entry routes are published, and the aide picks between them 'depending on their personal preferences and comfort level with testing': Retest without retraining — a DPS criminal history check, a Request to Retest for Nurse Aides in Expired Status filed in TULIP with the criminal history results and photo ID, then both exams again at the same $31/$41/$89 fees; or retrain and retest — the full 100-hour NATCEP (or the HHSC computer-based 60 hours plus 40 clinical hours) followed by both exams. Note that an expired certificate is not a revoked one. Revocation is different and is permanent: 'Revoked – The nurse aide's registration is revoked. Because substantiated findings of abuse, neglect, or misappropriation of resident property have been entered on the Texas Nurse Aide Registry, this individual is not employable as a nurse aide in a licensed nursing facility in the state of Texas.' HHSC: 'Can a nurse aide's certification be reinstated after it has been revoked? No, according to federal regulation at 42 Code of Federal Regulation, §483.156, findings of abuse, neglect and misappropriation of resident property must remain on the registry permanently. Exception: In the case of a finding of neglect only, a nurse aide may petition the state to remove the finding after the finding has been entered on the registry for one full year.' A fourth status, Suspended, applies where 'the nurse aide is listed as unemployable in the EMR', and a fifth, Prospective, means an applicant for a certificate. Before any finding is entered, HHSC gives the aide 'an informal reconsideration and a formal hearing' — a written request for reconsideration within 10 days of the notice letter, and for a formal hearing within 30 days of the notice of adverse action.",
   "reciprocity": "Texas calls it reciprocity and runs it as a registry-to-registry transfer. HHSC: 'Nurse aides that have an active certification in another state may transfer their certification to Texas.' The FAQ sets the eligibility test: 'How can I qualify for reciprocity? You can qualify if you are currently on the nurse aide registry in another state that is in compliance with applicable federal laws, and you complete the necessary HHSC-required documentation.' The steps HHSC publishes: complete a Texas DPS criminal history check for all last names ever held (a fee applies to each check); log into TULIP and complete a 'Request for Entry on the Texas Nurse Aide Registry through Reciprocity' application; upload the criminal history results, the other state's nurse aide certificate, a valid government-issued photo ID and a Social Security card; and, 'If the state that issued the applicant's certification doesn't provide an expiration date', also submit Form 5506-NAR. HHSC staff review the file and check the Employee Misconduct Registry, then issue the certificate through TULIP. No exam is part of this route. A military spouse alternative sits beside it: a spouse of an active-duty service member holding an active certificate elsewhere may instead take the Military Spouse Stationed in Texas Waiver, under which 'HHSC will issue a Texas nurse aide certificate for three years, as long as the applicant maintains active status in the other state'; that route additionally requires the military ID, the spouse's military orders and proof of a current Texas address, and 'The applicant chooses whether to pursue this waiver or reciprocity.' For aides moving the other way, HHSC publishes a directory of nurse aide registries in other states.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Texas HHSC — Nurse Aide Registry (the program's home page). Establishes that 'Texas Health and Human Services (HHSC) maintains a registry of all nurse aides who are certified to provide services in nursing facilities and skilled nursing facilities licensed by the agency'; that 'HHSC is contracted with Prometric to develop, score and report the results of the Nurse Aide Examination required for certification'; the five registry statuses and their verbatim definitions (Active, Expired, Prospective, Revoked, Suspended); 'HHSC no longer provides written verification of certified nurse aides'; the Employability Status Check Search equivalence statement; the July 5, 2023 move to TULIP; and the consolidation of the credentialing phone lines to 512-438-5800 effective July 1, 2026.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry\"}, {\"label\": \"Texas HHSC — Become a Certified Nurse Aide in Texas. Establishes all eight routes and their steps: the Traditional Nurse Aide Route with '60 hours of classroom and 40 hours of clinical' or the HHSC 60-hour CBT; Reciprocity ('Nurse aides that have an active certification in another state may transfer their certification to Texas'); the Military Spouse Stationed in Texas Waiver and its three-year certificate; Out-of-State Training; Equivalent Military Training ('military training of 100 hours or more'); RN/LVN Graduate; RN/LVN Student; Training Program Closed; and the pre-July-1-1989 Request for Waiver of Nurse Aide Training and Competency Evaluation. Also establishes the NATCEP approval conditions, the DPS criminal history check with its per-check fee, the Employee Misconduct Registry screen, and that 'HHSC staff issue the certificate' once Prometric's scores reach TULIP.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/become-a-certified-nurse-aide-texas\"}, {\"label\": \"Texas HHSC — Renew or Make Changes to a Nurse Aide Certificate in Texas. Establishes the five renewal options (aide-filed, employer-filed, retrain-and-retest, retest-only, military-prioritised), that renewal may begin 'three months prior to the expiration date on the certificate', the 24-hour in-service requirement 'every two years that includes training in geriatrics and the care of residents with a dementia disorder, including Alzheimer's disease', the Form 5506-NAR employment verification, and the name-change and address-change processes.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/renew-or-make-changes-a-nurse-aide-certificate-texas\"}, {\"label\": \"Texas HHSC — Nurse Aide Training and Competency Evaluation Program (NATCEP). Establishes the training-hours rule in the state's own words: 'Each NATCEP must provide a minimum of 100 clock hours of training, including: 60 clock hours of classroom training that doesn't involve direct resident care; 40 clock hours of hands-on resident care in a nursing facility'; the 'At least 16 introductory hours' before direct client contact and the curriculum list; the permitted clinical site types and the 20-mile laboratory exception; the facility bars (RN waiver, extended survey, civil money penalty 'of not less than $5,000', denial of payment or temporary management); the free 60-hour computer-based classroom training and the warning that 'The CBT course is a free course'; the statement that the CBT 'will not satisfy the 24 hours of in-service education'; the NATCEP screening duties; and the pointer to 26 TAC ch. 556.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-training-competency-evaluation-program-natcep\"}, {\"label\": \"Texas HHSC — Nurse Aide In-Service Education. Reproduces 26 TAC 556.9 verbatim — 'Effective September 1, 2013, a nurse aide renewing a certification must complete at least 24 hours of in-service education every two years that includes training in geriatrics and the care of residents with a dementia disorder, including Alzheimer's disease' — and establishes the free six-module HHSC in-service series at 2 credit hours each with a 70% minimum score, the separate five-module Infection Control series, and the requirement to print and keep each course certificate.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-service-education\"}, {\"label\": \"Texas HHSC — NAR Credentialing FAQs. Establishes 'Neither the federal regulation nor state rule imposes a minimum education requirement for nurse aides'; the retest limit ('may re-test twice... must go through the training again' after three failures); the reciprocity eligibility test; the four-month nurse-aide-in-training window; 'your employability depends upon the current status of your certification. If you are not in \\\"Active\\\" status on the Nurse Aide Registry, you are not employable, even if you have a copy of your certificate'; the two-year employment verification cycle; the permanence of revocation under 42 C.F.R. 483.156 with the one-year neglect-only petition; and the 10-day and 30-day deadlines for informal reconsideration and a formal hearing.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/nar-credentialing-faqs\"}, {\"label\": \"Texas HHSC — NAR Statutes and Rules. The agency's own citation list, naming 'Texas Administrative Code, Title 26, Part 1, Chapter 556: Nurse Aides' and 'Texas Health and Safety Code, Title 4, Chapter 250' and supplying the URLs used in the legal basis.\", \"url\": \"https://www.hhs.texas.gov/business/licensing-credentialing-regulation/long-term-care-credentialing/nurse-aide-registry/nar-statutes-rules\"}, {\"label\": \"Prometric — Texas Nurse Aide program page. The exam contractor's Texas page, linked by HHSC from the Nurse Aide Registry page. Establishes the candidate resources, the ADA route ('Select your requested accommodations in the TX Nurse Aide Portal and email the required documentation to HHSC'), the scheduling portals, the published Clinical Skills Checklist, and the pointer back to HHSC's system for CNA verification.\", \"url\": \"https://www.prometric.com/exams/nurseaide-tx\"}, {\"label\": \"Texas Certified Nurse Aide Candidate Information Bulletin (Prometric, published on the Texas Nurse Aide page HHSC links). Establishes the exam fee schedule (Written $31, Oral $41 including the Reading Comprehension exam, Clinical Skills $89, 'Newly Trained, Lapsed, or Re-tester'), 'Testing fees are nonrefundable and nontransferable', the $25 reschedule fee at 5-29 days and the loss of fee inside 5 days, the written test structure ('60 multiple-choice questions... 90 minutes'), the clinical skills structure ('scored on five skills... three assigned skills... Handwashing and Indirect Care' and 'To pass the Clinical Skills test, you must pass all five skills'), the sixth-grade reading level standard, the English-only skills exam versus the English-and-Spanish competency exam, the three-attempt limit and the 24-month post-training testing deadline, and the expired-status trigger and retest requirement.\", \"url\": \"https://www.prometric.com/files/Nurse-Aide/TX-CNA-CIB.pdf\"}, {\"label\": \"Texas HHSC — TULIP public search (nurse aide / employability status verification).\", \"url\": \"https://tulip.hhs.texas.gov/TULIP/s/public-search\"}]",
   "page_url": "https://licensingatlas.com/cna/tx-cna/"
  },
  {
   "page_id": "ut-cna",
   "state": "Utah",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Utah Nursing Assistant Registry (UNAR) — defined in Utah Admin. Code R432-45-2(23) as 'the Utah Nursing Assistant Registry and is the state agency that ... certifies nurse aides who have completed a NATCEP and passed the competency evaluation', maintains the nurse aide registry and the abuse registry, approves training programs and test sites, grants reciprocity, and renews certifications. The rule sits in the Health and Human Services, Health Care Facility Licensing title (R432), and the state survey agency that enforces UNAR's standards and investigates abuse is the Office of Licensing (OL) in the Division of Licensing and Background Checks within the Department of Health and Human Services (R432-45-2(20), R432-45-6(4)-(5)). The Medication Aide credential is a separate license issued by a different agency — the Division of Professional Licensing (DOPL) in the Department of Commerce.",
   "board_url": "https://utahcnaregistry.com/",
   "application_url": "https://utahcnaregistry.com/become-a-cna-in-utah",
   "renewal_cycle": "Every two years, and the renewal test is documented paid work rather than coursework. The rule sets the standard: 'Renewal means the process UNAR conducts every 24 months to verify that each CNA has provided at least 200 hours of compensated nursing or nursing-related services under the direction of a licensed nurse' (R432-45-2(18)), and 'UNAR shall process renewals for each CNA who has performed a paid service for at least 200 hours of nursing or nursing-related services under the direction of a licensed nurse during the 24 months following the completion date of the NATCEP or certification renewal' (R432-45-6(3)). How it is documented: 'Your Renewal Notice Form must be signed by a licensed nurse, an authorized human resources representative, or an administrator, to verify you have worked 200 paid hours under the direction of a licensed nurse. Return the signed form to the UNAR office before your expiration date' (UNAR State Certification Handbook). If one employer cannot account for all 200 hours, 'print off as many Renewal Forms as you need' and submit them together. Where the form comes from: 'Renewal Notice Forms are available in your TMU account 90 days prior to your expiration date and six (6) months after your expiration date.' Notice: 'Reminder notifications are emailed and sent to your TMU account 90, 60, and 30 days prior to your expiration date. A Renewal Notice Form will be mailed to the address on file 45 days prior to your expiration date' — but a CNA who has ticked 'Unlisted from Phone and Mailing Lists' in TMU 'will not receive these notifications and must keep track of your renewal due date.' What does not count: 'Hours used to renew your CNA certificate must be paid hours. Volunteer hours, nursing school clinical hours, and out of country missionary work do not count toward the 200 paid hour requirement.' Hours worked in another state can be used only if 'you must have an active certification, and be in good standing, in the state where you are currently working.' A CNA on the abuse registry cannot renew at all: 'Individuals listed on the Abuse Registry are not eligible for renewal.' After renewing: 'Your new CNA Certificate with Wallet Card will be mailed out within a week following the day you were recertified', and processing a renewal takes 7-10 business days. Submission is by email to UNAR or by post — 'UNAR does not have a fax machine.' A CNA leaving on a religious mission is told to call the office before departing if the certificate will expire while away.",
   "ce_hours": "None. Utah requires no continuing education, no in-service hours and no refresher course as a condition of keeping a CNA certificate — the renewal condition is 200 paid hours of nursing or nursing-related work under a licensed nurse in the preceding 24 months, and nothing else. R432-45-2(18) and R432-45-6(3) state the work requirement and contain no education element; R432-45 contains no continuing-education provision anywhere in its eight sections; and UNAR's answer to 'What is required to renew my certificate?' lists only the federal work rule, the 200-hour Utah rule, and a renewal form signed by an LPN, RN or NP. Sources checked: Utah Admin. Code R432-45 in full, UNAR's Common Questions page including its entire Renewing Your Certificate section, UNAR's Become a CNA page, and the UNAR State Certification Handbook (3rd Edition V3, November 2024) including its Renewal Requirements and Expired Certificates articles. The one education-shaped obligation that recurs in Utah's rule runs to the training program rather than to the certified aide: a NATCEP's program director must be able to 'provide at least three hours consulting time per month at renewal application for an existing NATCEP' (R432-45-5(11)(a)(iii)), and UNAR reapproves each program 'at least every two years' (R432-45-7(2)). Federal in-service training obligations that fall on nursing facilities are not addressed by R432-45 and are not a condition of a Utah CNA's certification; no Utah source read states one, so this page claims none.",
   "exam": "Two parts, both required: a written knowledge exam and a manual skills exam. Written — the UNAR State Certification Handbook gives the shape exactly: 'The written knowledge exam consists of 75 multiple-choice questions. To pass the written knowledge exam test candidates must receive a minimum score of 75%. This means test candidates must answer a minimum of 57 questions correctly to pass this portion of the competency evaluation. Test candidates have up to two (2) hours to complete the exam.' The published blueprint totals 75 questions: Intro to Healthcare and Residents Rights 13, Basic Nursing Skills 13, Personal Care 13, Infection Prevention and Control 8, Safety 8, Mental Health/Illness and Cognitive Impairment 9, Body Systems 7, Rehabilitation and Restorative Care 4. The rule states the same pass mark from the registry side: the registry identifies each individual who 'passed the written competency evaluation with a score of 75' (R432-45-6(1)(b)). Skills — 'UNAR requires that each student completing a nursing assistant training program learns, and is able to demonstrate, the ability to competently and safely perform more than 70 skills ... Of the 70+ skills learned, 20 have been identified for inclusion in the skills exam by the UNAR Test Advisory Committee ... test candidates will be expected to demonstrate five (5) random skills during the evaluation with a skills observer at a UNAR approved test site. To pass the skill exam, test candidates must receive a minimum score of 80% for each skill performed, including 100% of key steps, and complete testing within 45 minutes.' One skill is drawn from each of five categories the State Certification Handbook names in full: Vital Signs Skills, Oral Care/Feeding Skills, Ambulate/Positioning/Transfer Skills, Toileting Skills, and Miscellaneous Skills - the last of which is 'Handwashing, Anti-Embolism Stocking (One Leg), Dressing Resident: Affected Arm, Empty Down Drain Bag and Record Urine Output, Occupied Draw Sheet Change', so handwashing is a testable skill in its own right and not only a step inside another one. The rule matches: the registry lists those who 'passed the skills competency evaluation with a score of 80% for each skill performed, including 100% of the required key steps' (R432-45-6(1)(c)). Attempts — three per exam, then retraining: 'Test candidates have three (3) chances to pass each exam', and the rule requires UNAR to inform each candidate 'that after three failed attempts on the written, audio, or skills component of the competency evaluation, the candidate shall complete re-training with an approved NATCEP' (R432-45-4(9)(d)). There is no cooling-off period — 'There is no waiting period before you can reschedule if you fail either your manual skills exam or written knowledge exam' — but the one-year window from program completion still applies to every retest. Language and audio — 'An audio version of the written knowledge exam is available to all students and is not considered an ADA accommodation', selected in the candidate's TMU profile before scheduling; the rule requires it ('each written test is available with audio narration', R432-45-4(2)(a)). 'The official language for the competency evaluation is English. Test candidates must be able to read, write, communicate, and document in English. The written knowledge exam does have a Spanish translation feature included with each test question.' Word-to-word translation dictionaries are allowed if checked by site staff; third-party online translation tools are not. Scheduling and no-shows — 'All candidates may cancel or reschedule an existing exam appointment in TMU by 4 pm two (2) business days prior to the scheduled exam day', and 'If you fail to arrive for your scheduled testing appointment, you will be considered a no-show and will forfeit your testing fee.' A cell phone or smart watch in view is treated as cheating: 'Absolutely not. Having your cell phone out or smart watch in view is considered cheating and you will be denied certification.' Challenging a result — only the skills exam can be challenged: 'If you believe your manual skills exam was scored inaccurately, you may request a review of your exam by submitting a completed Skills Exam Results Review Form within 14 days of your testing event ... There is no method of challenging your written knowledge exam.' The review fee is refunded if the review goes the candidate's way.",
   "fees": "UNAR publishes a single fee list on its home page, and it contains no initial application fee and no on-time renewal fee — the cost of first certification is the two exam fees. The published list: 'Competency Exam: Manual Skills Exam (each attempt) $55; Competency Exam: Written Knowledge Exam (each attempt) $55; Duplicate Certificate with Wallet Card (digital and mailed) $15; Duplicate Certificate with Wallet Card (mailed) $10; Expired Certificate Competency Exam Fee $110; Name Change $15; Reciprocity Application $50; Renewal Late Fee (1 day - 6 months late) $40; Skills Exam Results Review Fee $20.' So a first-time candidate who passes both parts on the first attempt pays $110 in state fees, and each retest costs $55 for the part being retaken — 'The test candidate is responsible for paying the current testing fee for any retests that may be needed.' How payment works: testing fees are paid inside the candidate's TMU account before an appointment can be scheduled; late fees and approved application fees are paid through a secure link UNAR emails after processing. UNAR restricts the instruments it will take: 'UNAR does not accept cash, personal checks, money orders, or cashier's checks as payment for late fees. These will be returned to you and will delay the processing of your renewal form or application.' Payment on an approved application must be made within three weeks 'otherwise your application will be denied and deleted from our system.' Refunds: 'Unused testing fees are refundable up to six (6) months after payment is made. After that 6-month period, unused testing fees are non-refundable. Unused testing fees will remain available in your TMU account.' Renewal late fees are non-refundable; Skills Exam Results Review fees are refunded automatically 'if the review is found in the testing candidates favor'; application fees are refundable only before staff have processed the application. Not a state fee: tuition — 'Each CNA training program is run independently and sets their own program fees', and some programs 'are able to offer financial assistance, grants, or scholarships.' Checked across UNAR's home page fee list, its Common Questions page, its Become a CNA page, the UNAR State Certification Handbook and Utah Admin. Code R432-45, and not found: any application fee for initial certification, any fee for an on-time renewal, and any fee schedule inside the administrative rule itself.",
   "legal_basis": "[{\"citation\": \"Utah Admin. Code R432-45 (Health and Human Services, Health Care Facility Licensing — Nurse Aide Training and Competency Evaluation Program), effective May 8, 2025; Date of Last Change May 8, 2025; Notice of Continuation April 4, 2024\", \"what_it_governs\": \"The whole Utah nurse aide scheme: UNAR's status as the certifying state agency, the definitions of CNA, NATCEP, NAR and the abuse registry, the pathways to certification including waivers and reciprocity, the 100-hour training minimum and the 24-hour facility-practice minimum, the competency evaluation and its pass marks and three-attempt limit, testing-centre approval, the registry's required contents and its 24-month inactivity purge, the 24-month/200-hour renewal standard, and program approval, review and withdrawal. The rule's own authority line names a single law, and it is federal: 'Authorizing, and Implemented or Interpreted Law: 42 CFR 431.10.'\", \"url\": \"https://adminrules.utah.gov/public/rule/R432-45/Current%20Rules\"}, {\"citation\": \"42 CFR Part 483, Subpart D — Requirements for States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants (including 42 CFR 483.150-.158, with 483.156 on the registry)\", \"what_it_governs\": \"The federal frame Utah's programme implements: state approval of nurse aide training and competency evaluation programmes, the 75-hour federal training floor that Utah exceeds, the competency evaluation, the state nurse aide registry, and the registry's treatment of abuse findings. Utah's rule cites this body directly — 42 CFR 483.156(c)(1)(iv)(D) (2025) for what must be entered on the abuse registry within ten working days, and 42 CFR 483.156(c)(2) for removal of entries inactive 24 consecutive months. UNAR cites the same part to candidates for the renewal work requirement.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}, {\"citation\": \"Omnibus Budget Reconciliation Act of 1987 (Nursing Home Reform Act), Pub. L. No. 100-203, 101 Stat. 1330, Sec. 4211; and 42 U.S.C. 1396r(5)\", \"what_it_governs\": \"The statutes Utah names as authorising the programme. R432-45-1: OBRA Section 4211 and its listed subsections 'authorize the Nurse Aide Training and Competency Evaluation Program (NATCEP)', and 'The department uses NATCEP to carry out the requirements of 42 U.S.C. Sec. 1396r(5), which specifies requirements for nursing facilities to ensure nurse aides are trained according to federal requirements.' R432-45-6(4) adds that the state survey agency 'shall enforce the standards of UNAR described in Pub. L. No. 100-203, 101 Stat. 1330, Secs. 4211 and 4212.' The federal statutory text itself was not read as of August 16, 2026; everything stated here about OBRA is quoted from Utah's own rule.\", \"url\": \"https://adminrules.utah.gov/public/rule/R432-45/Current%20Rules\"}, {\"citation\": \"Utah Code Title 26B, Chapter 2, Part 7 (Penalties and Investigations), and Utah Admin. Code R380-600\", \"what_it_governs\": \"The enforcement side. R432-45-8: 'Any provider found in noncompliance with any statute or rule under the division may be subject to the penalties in Rule R380-600 and Title 26B, Chapter 2, Part 7, Penalties and Investigations.' This is the only Utah statutory citation in the rule. The Part's own text could not be read as of August 16, 2026 — the Utah Legislature's code viewer returned only its site navigation to every reading method tried — so no penalty amount or provision is stated on this page; the citation is recorded because Utah's rule points to it.\", \"url\": \"https://le.utah.gov/xcode/Title26B/Chapter2/26B-2-P7.html\"}, {\"citation\": \"Utah Admin. Code R432-35 (background screening) and Utah Code Subsection 64-13-48(8) (inmates), as cross-referenced by R432-45\", \"what_it_governs\": \"Two cross-references the rule relies on: R432-35 supplies the background-check standard for a training programme's director, instructors and employees with direct patient access (R432-45-5(4)), and Subsection 64-13-48(8) is the basis for excluding inmates both as candidates (R432-45-3(3)(d)) and as the audience of an approved programme (R432-45-5(1)(b)). Neither text was read as of August 16, 2026; they are named because Utah's nurse aide rule names them, and nothing on this page depends on their contents.\", \"url\": \"https://adminrules.utah.gov/public/rule/R432-45/Current%20Rules\"}]",
   "exam_vendor": "UNAR itself, delivered on the Testmaster Universe (TMU) platform. The rule keeps the examination in state hands: UNAR 'develops, updates, and validates the competency evaluation' (R432-45-2(23)(d)), the questions come 'from a pool of test questions' that UNAR maintains, periodically updates and validates (R432-45-4(2)(c)), UNAR 'shall use testing software to randomly select five tasks from the pool of the skills competency evaluation items' (R432-45-4(3)), and 'Only a UNAR-approved testing center may perform competency evaluations' (R432-45-4(4)). Utah therefore does not use a national vendor examination — there is no NNAAP, no Prometric and no Pearson VUE form here; the UNAR Test Advisory Committee approves the item pool and the skills list. The delivery software and the registry front end are one product: 'TMU is the software program that is used by UNAR to provide certification testing and maintain registry records' (UNAR State Certification Handbook). The TMU site's own terms of use identify the software's owner as Headmaster LLP. Testing is spread across the state through independent partner sites rather than a single vendor's centres: 'UNAR has independent testing site partners across the state in Blanding, Cedar City, Hurricane, Kaysville, Lehi, Logan, Moab, Ogden, Price, Richfield, Roosevelt, Salt Lake City, St. George, Tooele, and Vernal', and 'Each test site is run independently and sets their own schedule.' The skills observer must be a Utah-licensed RN in good standing with at least a year of experience caring for the elderly or chronically ill, who attends UNAR's mandatory training sessions and recuses from observing anyone they trained (R432-45-4(8)).",
   "training_hours": "100 hours total, of which at least 24 hours must be supervised practical training in a nursing care facility. Utah Admin. Code R432-45-5(6): 'A NATCEP shall provide at least 100 hours of supervised and documented training by a licensed nurse using curriculum containing: (a) basic nursing skills; (b) comprehensive orientation to the training program and the nursing assistant's role on the healthcare team; (c) communication and interpersonal skills; (d) infection control; (e) promoting resident independence; (f) respecting resident rights; and (g) safety and emergency procedures.' The clinical split is in the very next subsection — R432-45-5(7)(a): 'A NATCEP shall ensure each candidate ... completes at least 24 of the required 100 hours of supervised practical training in a nursing care facility.' UNAR states the same total on its own Become a CNA page: 'The nursing assistant certification process in the State of Utah requires test candidates to complete at least 100 hours of training in an UNAR-approved training program (NATCEP).' A narrow substitution exists for part of the clinical hours, and it needs permission each time: 'UNAR may approve a written request from a NATCEP to use a Type II assisted living facility for no more than eight of the 24 required hours of supervised practical training' if the program identifies the facility and documents 'the lack of availability of nursing care facility locations' (R432-45-5(8)(a)). Two limits travel with it: a program 'may not continue supervised practical training in a Type II assisted living or nursing care facility if that facility's supervised practical training approval has been withdrawn by UNAR', and a nursing care facility on the federal NATCEP loss list may not host training unless it obtains a NATCEP loss waiver from the Office of Licensing or is reinstated after 'the mandatory two-year ban following placement on the NATCEP loss list' (R432-45-5(8)(b)-(c)). Utah's 100 hours sits 25 hours above the federal 75-hour floor. Note that the state does not publish a classroom/laboratory breakdown of the remaining 76 hours — R432-45 fixes the total and the facility minimum and leaves the rest to the program's UNAR-approved curriculum; R432-45 in full, UNAR's Become a CNA page and the UNAR State Certification Handbook were all checked, and no such breakdown is published.",
   "lapse_rule": "Utah runs three windows off the expiration date, and which one you are in decides whether you file a form, sit two exams, or start over. Window 1 — up to six months late: 'You may renew your certificate up to six (6) months after your expiration date by meeting all renewal requirements, submitting your completed renewal form to UNAR, and paying any late fees that may be due' (UNAR State Certification Handbook). The late fee is fixed: 'Renewal Late Fee (1 day - 6 months late) $40', charged from the first day after expiry and calculated from the postmark or the date the email was sent. Crucially the grace is procedural, not substantive: 'This 6 month period is not an extension to finish working the required 200 paid hours necessary to renew.' The rule supports the same result — 'A CNA with a Utah certificate that has been expired for fewer than six months and who had met each requirement before the expiration date may pay a late fee and have the certification reinstated as active for the remainder of the original 24-month renewal time frame' (R432-45-3(7)) — so reinstating late does not restart the two years. Window 2 — six to 24 months late: retake both exams. 'If you are between six (6) and 24 months expired, you can recertify by successfully passing the state written knowledge exam and manual skills exam. To apply for testing, submit the Expired Certificate Application', with three attempts allowed inside a two-year window (R432-45-3(4)(b)(ii)) and a published $110 Expired Certificate Competency Exam Fee. Window 3 — more than 24 months late: 'If you are more than 24 months expired, you are ineligible to test under our Expired Certificate Application. You will need to complete another Approved Training Program and pass the state competency exams.' Meanwhile, you cannot work: 'Working on an expired certificate is not allowed. Your employer can face disciplinary action', and 'If you have not become certified or have allowed your certification to expire, you may not work as a CNA or identify yourself as a CNA.' The 120-day new-hire window does not rescue a lapsed aide — UNAR: 'If your certification has expired or if you have ever held a Utah CNA certificate, this 120-day rule does not apply to you.' The registry entry itself also ages out: 'In accordance with 42 CFR 483.156(c)(2), UNAR shall remove entries for each individual whose certification has been inactive for 24 consecutive months unless the individual's registry entry includes documented findings of resident abuse, neglect, or misappropriation of resident property' (R432-45-6(7)); public visibility follows the same clock — 'Utah CNA certificate information is viewable by the public while a certificate is active and for 24-months after a certificate expires.' A separate and permanent bar: an abuse-registry finding. 'Utah CNA information is viewable on the Abuse Registry for life for substantiated allegations of resident abuse, neglect, or misappropriation of property by the CNA while employed at a Utah Medicare or Medicaid facility.' The Office of Licensing investigates; 'A CNA may request a hearing through the Division of Medicaid and Health Financing before a substantiated claim is entered into the registry' (R432-45-6(5)(b)); and the finding 'shall remain in the registry permanently unless: (i) the finding was made in error; (ii) the individual was found not guilty in a court of law; or (iii) the SSA is notified of the individual's death' (R432-45-6(6)(b)).",
   "reciprocity": "Utah calls it reciprocity, treats it as an application with documents and a fee, and refuses it outright to anyone whose home-state certification has lapsed. The rule: 'An individual may seek reciprocity from the UNAR if the individual provides the certification demonstrating that the individual is currently certified in another state with no findings in that state's abuse registry or on the UNAR abuse registry' (R432-45-3(5)); and the hard edge, 'An individual with an expired certification from another state shall complete a NATCEP in Utah' (R432-45-3(6)) — Utah does not offer out-of-state applicants the six-to-24-month retesting route it gives its own lapsed CNAs. What UNAR requires with the application: 'A copy of your current and valid photo ID (such as your driver's license or passport); A copy of your current and valid Social Security Card; A copy of your current and valid CNA certificate card or a screenshot of your on-line registry entry; Any other CNA certificates from other states that you hold or have held (current or expired).' Fee and timing: the published 'Reciprocity Application $50'; 'The time frame for verifying and approving your application is 1-3 business days. Once we receive notification that you have made your payment, processing time is 7-10 business days.' UNAR also lists the common failures: wrong date of birth, certificate number or expiration date; documents in HEIC format, which 'our system cannot open ... and will be rejected'; missing documents; unpaid fee. Working in Utah on an out-of-state card is not allowed, and UNAR says so directly: 'In order to work in Utah as a Certified Nursing Assistant (CNA), you must be certified in Utah. You cannot work as a CNA in Utah with an out of state CNA certificate, even if it is an active certificate.' Reciprocity is not a transfer — you keep both: 'No, your certificate remains in tact. Keep in mind that when you renew your CNA certificate in Utah this will not renew your certificates in any other states. If you wish to maintain certificates in other states, you will need to stay up-to-date with the renewal requirements of those states. Many CNA's hold dual certifications so that they can work as traveling CNA's.' UNAR describes the mechanism as endorsement in both directions: 'Reciprocity is the process a CNA goes through to have their current, active certification recognized through endorsement when moving into or out of Utah.' A person leaving Utah who needs proof for another state's registry files a Verification Letter Application, which UNAR processes in about 3-5 business days after payment.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Utah Administrative Code R432-45, Nurse Aide Training and Competency Evaluation Program (Utah Office of Administrative Rules, current rule, effective 05/08/2025). The controlling text for everything structural on this page: UNAR as 'the state agency' that certifies nurse aides (R432-45-2(23)), the definition of CNA (R432-45-2(4)), the 100-hour training minimum and 100-hour curriculum list (R432-45-5(6)), 'completes at least 24 of the required 100 hours of supervised practical training in a nursing care facility' (R432-45-5(7)(a)), the eight-hour Type II assisted living substitution (R432-45-5(8)), age 16 and the inmate exclusion (R432-45-3(3)), the 120-day employment window (R432-45-3(1)), the waiver of NATCEP routes and their attempt limits (R432-45-3(4)), reciprocity and the expired-out-of-state rule (R432-45-3(5)-(6)), the six-month late reinstatement (R432-45-3(7)), the written pass score of 75 and skills score of 80% with 100% of key steps (R432-45-6(1)), three attempts then retraining (R432-45-4(9)(d)), the registry's required contents and visibility windows (R432-45-4(9)(b)), the 24-month/200-hour renewal standard (R432-45-2(18), R432-45-6(3)), the abuse-registry entry and permanence rules (R432-45-6(5)-(6)), the 24-month inactivity purge (R432-45-6(7)), and the enforcement cross-reference (R432-45-8).\", \"url\": \"https://adminrules.utah.gov/public/rule/R432-45/Current%20Rules\"}, {\"label\": \"Utah Nursing Assistant Registry — Home. UNAR's self-description ('provides certification, renewal, and reciprocity services for Certified Nursing Assistants in the State of Utah. UNAR also approves and oversees all nursing assistant training programs and instructors') and the complete published CNA fee list: Manual Skills Exam $55 each attempt, Written Knowledge Exam $55 each attempt, Duplicate Certificate with Wallet Card $15 digital and mailed / $10 mailed, Expired Certificate Competency Exam Fee $110, Name Change $15, Reciprocity Application $50, Renewal Late Fee (1 day - 6 months late) $40, Skills Exam Results Review Fee $20. Also lists the CNA forms (ADA Accommodations, Duplicate Certificate, Expired Certificate Application to Test, Name Change/Correction, Nursing Student Application to Test, Reciprocity Application, Request for Unique Identifier, Skills Exam Results Review, Verification Letter) and the CNA policies (Accommodations, Behavioral Misconduct and Unlawful Acts, Cheating Policy-State Exam, Reimbursement / No-Show, Skills Exam Results Review, Translation).\", \"url\": \"https://utahcnaregistry.com/\"}, {\"label\": \"Utah Nursing Assistant Registry — Become a CNA in Utah. Establishes the OBRA background in UNAR's own words, 'The nursing assistant certification process in the State of Utah requires test candidates to complete at least 100 hours of training in an UNAR-approved training program (NATCEP)', 'To earn a certification in the State of Utah, an individual must be at least 16 years of age, complete a UNAR-approved training program, and pass both the State Written Knowledge Exam and State Manual Skills Exam', the one-year/three-attempt rule for first-time candidates, the 200-hour renewal standard, the six-month/24-month expiry windows, the nursing-student and expired-nurse waiver routes, and the definition of reciprocity as recognition 'through endorsement when moving into or out of Utah'.\", \"url\": \"https://utahcnaregistry.com/become-a-cna-in-utah\"}, {\"label\": \"Utah Nursing Assistant Registry — Common Questions. The state's own FAQ, and the source for the testing rules (two-business-day reschedule deadline, no-show forfeiture, the one-year testing window with 'Extensions are not given ... for any reason', no waiting period between retests, ID requirements, the cell-phone/smart-watch cheating rule, the 14-day Skills Exam Results Review and the absence of any challenge to the written exam), the training-and-fee rules ('The student is responsible for payment of all training and testing fees unless they are employed by or have received an offer of employment from the facility that is providing the training program'), the refund policy, the 120-day rule and its exclusion for anyone who has ever held a Utah certificate, the foreign-credential answer ('required to take our 100-hour CNA course'), the out-of-state-card prohibition, the full reciprocity document list and timings, the renewal mechanics and the exclusion of volunteer, clinical and missionary hours, and the Medication Aide boundary ('the Utah Nursing Assistant Registry (UNAR) does not provide training, administer exams, endorse licensing from other states, or renew Medication Aide licenses').\", \"url\": \"https://utahcnaregistry.com/common-questions\"}, {\"label\": \"Utah Nursing Assistant State Certification Handbook, 3rd Edition V3, November 2024 (UNAR). The examination detail: 'The written knowledge exam consists of 75 multiple-choice questions. To pass ... a minimum score of 75%. This means test candidates must answer a minimum of 57 questions correctly ... up to two (2) hours to complete the exam', the 75-question subject blueprint, 'Of the 70+ skills learned, 20 have been identified for inclusion in the skills exam by the UNAR Test Advisory Committee ... five (5) random skills ... a minimum score of 80% for each skill performed, including 100% of key steps, and complete testing within 45 minutes', 'TMU is the software program that is used by UNAR to provide certification testing and maintain registry records', the list of independent testing-site towns, the audio and Spanish-translation provisions, certificate mailing in 7-10 business days, the registry visibility windows, the renewal notice schedule (90/60/30 days plus a mailed form at 45 days), the $40 late fee, 'Individuals listed on the Abuse Registry are not eligible for renewal', and the three expiry windows.\", \"url\": \"https://utahcnaregistry.com/media/du5mostz/3rd-edition-handbook-v3.pdf\"}, {\"label\": \"Utah Nursing Assistant Registry — What Can a CNA Do. Establishes the scope-of-role statement ('Certified Nursing Assistants are not licensed healthcare providers. CNAs must work under the direction of a licensed nurse'), the delegation rule ('Nursing tasks must be delegated by a licensed nurse'), UNAR's disclaimer that 'It is not within UNAR purview to provide legal advice', and the published list of skills taught in a UNAR-approved training program.\", \"url\": \"https://utahcnaregistry.com/what-can-a-cna-do\"}, {\"label\": \"Utah CNA online registry (public lookup), the tool UNAR directs candidates and employers to. Its own form controls establish the four search options listed under Verify a license on this page — Name, SSN, Certification Number and Misconduct — plus a 'Download Misconduct List' function.\", \"url\": \"https://ut.tmutest.com/search\"}, {\"label\": \"Testmaster Universe (TMU) Utah — Terms and Conditions of Use. Establishes the identity of the software's owner: the terms are written throughout in the name of Headmaster LLP ('Permission is granted to temporarily download one copy of the materials on Headmaster LLP's Website ...'), which is why this page names Headmaster LLP as the platform operator rather than inferring it.\", \"url\": \"https://ut.tmutest.com/terms\"}, {\"label\": \"Utah Division of Professional Licensing (DOPL), Department of Commerce — Nursing: Apply for a Medication Aide License. Establishes the separate-credential boundary from the other side: the MACE examination, fingerprint requirement, 'Be ready to upload your official verification of current certification in good standing as a Certified Nursing Assistant with the Utah Nursing Assistant Registry', the Verification of Active Practice as a Certified Nurse Aide form, the two required letters of recommendation, and 'Aside from a military member or military spouse, there are no \\\"licensing by endorsement\\\" options available for medication aides.'\", \"url\": \"https://commerce.utah.gov/dopl/nursing/apply-for-a-license/medication-aide/\"}]",
   "page_url": "https://licensingatlas.com/cna/ut-cna/"
  },
  {
   "page_id": "va-cna",
   "state": "Virginia",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Virginia Board of Nursing, Department of Health Professions (DHP) — the same board that licenses registered nurses, practical nurses, advanced practice registered nurses, licensed certified midwives and massage therapists. It certifies nurse aides, registers medication aides, maintains the nurse aide registry, and approves nurse aide education programs. Office: Perimeter Center, 9960 Mayland Drive, Suite 300, Henrico, Virginia 23233-1463. Unlike most states, Virginia does not split this occupation between a health department and a licensing agency — one board owns training approval, certification, the registry and discipline.",
   "board_url": "https://www.dhp.virginia.gov/Boards/Nursing/",
   "application_url": "https://www.dhp.virginia.gov/Boards/Nursing/ApplicantResources/ApplyforLicense/NurseAide/",
   "renewal_cycle": "Annual after a two-year first term — an unusual structure, and both halves are sourced. The first term: 'Initial certification shall be for two years' (18VAC90-25-70(C)); the state-linked handbook repeats it — 'Your initial nurse aide certification is valid for two (2) years.' Thereafter, annual: 'Each certificate issued to practice as a nurse aide shall be renewed annually upon payment of any specified fee' (Va. Code 54.1-3026), and the Board's fee table heads the CNA column 'Renewal (Annual) $30'. What you attest to — and note the mismatched look-back: 'The certified nurse aide shall annually submit a completed renewal application with the required fee and attestation of performance of nursing-related activities for compensation within the two years immediately preceding the expiration date' (18VAC90-25-80(A)(2)). So the filing is yearly but the work test looks back two years, which tracks the federal 24-month standard. The handbook states the same rule from the candidate's side: 'You are required to personally attest that you have been employed for pay performing nursing-related activities within the previous two (2) years. To be renewed and maintained on the Registry, you must meet the work requirement mentioned above or you will be required to retake the NNAAP Examination to demonstrate continued competency.' The consequence of not meeting it is spelled out in the rule: 'A certified nurse aide who has not performed nursing-related activities for compensation during the two years preceding the expiration date of the certification shall repeat and pass the nurse aide state examination prior to applying for renewal of certification' (18VAC90-25-80(A)(4)). Notice — two different lead times, both official: the regulation says 'No less than 30 days prior to the expiration date of the current certification, a notice for renewal shall be sent by the board to the address of record' (18VAC90-25-80(A)(1)), while the Board-linked handbook says 'At least sixty (60) days prior to the expiration date of your certificate, a renewal notice will be mailed to your last address on record.' This page reports both and resolves neither; either way the notice is not a condition of the duty — 'Failure to receive the application for renewal shall not relieve the certificate holder of the responsibility for renewing the certification by the expiration date' (18VAC90-25-80(A)(3)), and the handbook adds the practical fallback: 'If you do not receive your renewal notice by the middle of the month in which your certificate is due to expire, contact the Board of Nursing.' One cycle this section does not settle: the advanced certified nurse aide's. The Board renews it concurrently with the basic certificate — so annually, at $20 on its fee table's 'Renewal (Annual)' column — while Va. Code 54.1-3025.1(B) says an advanced certificate 'shall be renewed biennially'. The continuing-education section states both. Employment can be documented on the Board's Employment Verification Form - Certified Nurse Aide, which asks for employer name and address, start and end dates, role or job held, and the CNA certificate number, and is returned to nurseaide@dhp.virginia.gov.",
   "ce_hours": "None for the basic Certified Nurse Aide certificate. Virginia's renewal condition is paid nursing-related work in the preceding two years, attested annually, and nothing else: Va. Code 54.1-3026 requires 'proof of compliance with any requirements of law and regulation concerning continued employment or competence', and the Board implemented that as the work attestation at 18VAC90-25-80(A)(2) with no education element anywhere in 18VAC90-25. Sources checked: 18VAC90-25 in full (sections 10, 15, 16, 70, 71, 72, 80, 81, 100, 110, 120), Va. Code 54.1-3022 through 54.1-3028.1, the Board's Nurse Aide application page, its Fees page and the state-linked candidate handbook. Continuing education exists only at the advanced level, and it is modest — though how often the advanced certificate renews is itself a statute-versus-regulation conflict, and this page reports both sides. The statute says every two years: 'An advanced certificate issued to a certified nurse aide shall be renewed biennially upon payment of any specified fee. The certified nurse aide shall submit proof of compliance with any requirements of law and regulation concerning competence as established by the Board' (Va. Code 54.1-3025.1(B), enacted 2001 c. 448 and never amended). The Board says every year, twice over: its regulation ties the advanced certificate to the basic one — 'An advanced certification shall be renewed concurrently with the renewal of the basic certification as a nurse aide in Virginia' (18VAC90-25-120(B)) — and the basic certificate renews annually (Va. Code 54.1-3026; 18VAC90-25-80(A)(2)); and the Board's published fee table puts the Advanced Certified Nurse Aide row under a column headed 'Renewal (Annual)', at $20. Both texts are Virginia's own and this page resolves neither. What is not in doubt is what the Board actually asks for at renewal: an advanced certified nurse aide renews concurrently with the basic certificate by 'Attesting to completion of at least three contact hours per year of continuing education and training in any of the competency areas identified in the advanced certification training program. The board may grant an extension or waiver of the continuing education requirement based on good cause shown by the certified nurse aide' (18VAC90-25-120(B)(2)). Reinstating an advanced certificate requires evidence 'that the applicant has completed all required hours of continuing education and training' (18VAC90-25-120(D)(4)). By contrast the Board's Registered Medication Aide credential carries a separate statutory continuing-training duty (Va. Code 54.1-3043), which is a different credential and not covered here.",
   "exam": "Two parts, both required: a written (or oral) examination and a skills evaluation. 'There are two parts of the NNAAP Examination, the Written (or Oral) Examination and the Skills Evaluation. You must pass both parts to be listed on the Virginia Nurse Aide Registry.' Written: 'The written part of the test is comprised of seventy (70) multiple-choice questions written in English.' Oral, as an alternative for candidates who read English with difficulty: 'The Oral Examination includes sixty (60) multiple-choice questions and ten (10) reading comprehension/word recognition questions', and it must be requested at registration — 'If you want to take the Oral Examination, you must request it when you submit your registration form.' Skills: 'For the Skills portion test, you will be asked to perform five (5) randomly selected nurse aide skills. You will be rated on these skills by a Nurse Evaluator.' The subject areas are fixed by statute rather than by the vendor — Va. Code 54.1-3025 requires the clinical competency evaluation to include '1. Basic nursing skills; 2. Personal care skills; 3. Recognition of mental health and social services needs; 4. Basic restorative services; and 5. Resident or patient rights.' Attempts and window: three attempts and two years from completion of training, after which the candidate 'shall reenroll and successfully complete another approved nurse aide training program before reapplying' (18VAC90-25-71(B)); the handbook adds that 'Both exams must be passed under the same application.' The handbook is not consistent on the deadline: its eligibility article matches the regulation ('within 24 months of training program course completion date'), but its exam-results article says 'If you are E1 eligibility route, you must pass the exam within twelve (12) months from the course completion date.' Both statements are given here; the regulation's two years is the rule the Board adopted. A medical restriction most states do not spell out: 'Federal law states that you cannot take the Skills Evaluation if you are on restricted activity or light duty for medical reasons. You must be able to complete all required skills included in the Skills Evaluation. There are no exceptions to this rule. Candidates who are on light duty are not permitted to take the Skills Evaluation, but light duty does not prevent you from taking the Written Examination.' What Virginia does not publish, checked across 18VAC90-25, 18VAC90-26, the Board's nurse aide and fees pages and the state-linked handbook articles read: a passing score or a time allowance. The Board reserves the passing standard to itself by rule and does not print the number, and the handbook articles read here do not state one. Candidates who need to challenge a result use the handbook's Grievance Process; the Board separately publishes a skills list and an accommodations request form through its contractor.",
   "fees": "Virginia charges no application fee for the basic nurse aide certificate — the Board's published fee table lists 'Certified Nurse Aide (CNA)' with an Application of $0, an annual Renewal of $30, a Reinstatement of $30, a Duplicate CNA of $0 and a Returned Check of $50. The regulation matches on the renewal side and simply contains no application fee: 18VAC90-25-16(A) lists 'Annual renewal for certified nurse aide $30', 'Handling fee for returned check or dishonored credit card or debit card $50', and then only the advanced-certification fees — application $25, renewal $20, reinstatement $30. 'Fees shall not be refunded once submitted' (18VAC90-25-16(B)). The examination is separate and is not a state fee. The state-linked candidate handbook publishes it: Written Examination Only $45, Oral Examination Only $45, Skills Examination Only $95. 'You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test', so a first sitting is $140. 'Fees are not refundable', and 'Payment must be made in the form of a credit card, debit card, single use card, or electronic voucher. Vouchers can be purchased by the training programs.' Who actually pays: 'Under federal and Virginia laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees, including individuals required to retest.' Tuition is also not a state fee, and for many students it is not a fee at all — an approved program must 'Impose no fee for any portion of the program, including any fees for textbooks or other required course materials, on any nurse aide student who, on the date on which the student begins the program, is either employed or has an offer of employment from a facility' (18VAC90-26-20(B)(2)). For context, the same Board table prices a registered nurse license at $190 application and $140 biennial renewal and a Registered Medication Aide at $50 application and $30 annual renewal — the nurse aide certificate is the cheapest credential the Board issues. Payment method for Board fees: 'Fees shall be paid by check or money order made payable to the Treasurer of Virginia and forwarded to the board. Online payments shall be paid by debit or credit card (Visa, MasterCard, American Express or Discover). All fees are nonrefundable.' Checked and not found: any late fee or penalty for a late CNA renewal (the Board's table shows late-renewal surcharges for RN, LPN, APRN, LMT and RMA but the CNA row carries none), and any endorsement-specific fee.",
   "legal_basis": "[{\"citation\": \"Code of Virginia, Title 54.1, Chapter 30, Article 4 (Certification of Nurse Aides) — 54.1-3022 (title protection), 54.1-3023 (application by competency evaluation; military credit), 54.1-3024 (application by endorsement), 54.1-3025 (certification by competency evaluation and its five subject areas), 54.1-3025.1 (advanced certification), 54.1-3026 (annual renewal), 54.1-3027 (exclusions), 54.1-3028 (pre-October 1989 registry additions), 54.1-3028.1 (nurse aide education programs; 120-hour statutory minimum)\", \"what_it_governs\": \"The certificate itself: who may use the title, what an applicant must show, the endorsement standard including substantial equivalence and a clean out-of-state record, the statutory content of the competency evaluation, the advanced certificate, the annual renewal duty, the two exclusions, and the statutory program-length minimum that the Board's regulation exceeds.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/\"}, {\"citation\": \"18VAC90-25 (Regulations Governing Certified Nurse Aides) — sections 10, 15, 16, 70, 71, 72, 80, 81, 100, 110 and 120\", \"what_it_governs\": \"The operative certification rules: the fee schedule, the identification, name-change and 30-day address duties, the two-year initial certification term, the three entry routes and the two-year/three-attempt limit, the five endorsement conditions, annual renewal with a two-year work attestation and the retest consequence, the 90-day reinstatement line and the permanent bar after an abuse finding, the once-only petition to remove a single-occurrence neglect finding, the board's detailed definition of unprofessional conduct for nurse aides, and the advanced certificate's eligibility, renewal, three-contact-hour continuing education, 90-day late renewal and reinstatement.\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter25/\"}, {\"citation\": \"18VAC90-26 (Regulations for Nurse Aide Education Programs) — sections 10, 20, 30, 40, 50, 60, 70, 80 and 90\", \"what_it_governs\": \"The source of the 140-HOUR program minimum (18VAC90-26-50(C)), the 20 laboratory hours, the 24 hours of instruction before direct client contact, the 40 hours of clinical direct client care excluding observation, the exclusion of employment orientation from the 140, the twelve-heading curriculum, the instructor and program-coordinator qualifications and the 10:1 clinical ratio, the no-fee rule for employed students, the record-keeping duties including the NNAAP pass-rate record and the certificate of completion, and the requirements for approving an advanced certification education program.\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter26/\"}, {\"citation\": \"Code of Virginia 54.1-3007 (Refusal, revocation or suspension, censure or probation) and 54.1-3005.1 (Criminal history background checks)\", \"what_it_governs\": \"Section 54.1-3007 supplies the eight statutory grounds on which the Board may refuse, suspend or revoke a nurse aide certificate — including conviction of a felony or a misdemeanour involving moral turpitude, out-of-state discipline, and abuse, negligent practice or misappropriation of a patient's or resident's property. Section 54.1-3005.1 is cited for what it does not reach: it requires fingerprints of applicants for licensure as a practical nurse, registered nurse or licensed massage therapist, and does not extend to nurse aides.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/section54.1-3007/\"}, {\"citation\": \"42 CFR Part 483, Subpart D — Requirements for States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants, particularly 42 CFR 483.151 and 483.152\", \"what_it_governs\": \"The federal frame Virginia's programme sits inside. The Board incorporates it directly: an endorsement applicant must be a graduate of a program 'that meets the requirements for clinical training and competency set forth in 42 CFR 483.152' (18VAC90-25-72(1)), and an approved program's clinical setting must not 'have been subject to penalty as provided in 42 CFR 483.151(b)(2) ... in the past two years' unless the facility holds a state-survey-agency waiver (18VAC90-26-20(B)(1)(e)). The Board also links 42 CFR 483.152 from its own education-programs page as the federal requirement for approving a training program. The federal text itself was not read as of August 16, 2026; it is cited because Virginia's regulations incorporate it by reference.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Credentia, administering the National Nurse Aide Assessment Program (NNAAP). Virginia names both in its own material. The regulation defines the acronym — 'NNAAP means National Nurse Aide Assessment Program' (18VAC90-26-10) — and requires each program to keep 'A record of the graduates' performance on the state-approved nurse aide certification examination (NNAAP)' (18VAC90-26-50(A)(2)); the Board publishes NNAAP pass rates by program on its own Testing Pass Rates page. The Board's Nurse Aide application page sends candidates to the contractor by name: 'You will need to visit the Credentia website and schedule the Virginia Nurse Aide Competency Test (\"State Board\")', and links the Credentia self-help guides. The legal frame keeps the board in charge of the standard even though a vendor runs the test: 'The board may contract with a test service for the development and administration of a competency evaluation, which shall be a state examination', and 'The board shall determine the minimum passing standard on the state examination' (18VAC90-25-70(B)). Registration and scheduling run through a Credentia Platform account; the handbook notes the platform change for anyone with an older account — 'If you previously had an online Pearson VUE account (PCM) to register for examinations, you'll need to create a new Credentia Platform' account. Credentia's registration and scheduling service is at 1025 Greenwood Blvd., Suite 401, Lake Mary, Florida.",
   "training_hours": "140 clock hours under the Board's regulation — and 120 under the statute, which is the single most important number conflict on this page. The regulation, which is what a program must actually meet: 18VAC90-26-50(C) — '1. By May 12, 2023, the program shall be at least 140 clock hours in length, at least 20 hours of which shall be specifically designated for skills acquisition in the laboratory setting. 2. The program shall provide for at least 24 hours of instruction prior to direct contact of a student with a client. 3. Clinical training in clinical settings shall be at least 40 hours of providing direct client care. Hours of observation shall not be included in the required 40 hours of clinical training. 4. Time spent in employment orientation to facilities used in the education program must not be included in the 140 hours allotted for the program.' The statute, still on the books and still saying something smaller: 'Nurse aide education programs designed to prepare nurse aides for certification shall be a minimum of 120 clock hours in length' (Va. Code 54.1-3028.1, enacted 1999 c. 783, amended 2016 cc. 109, 582), followed by a curriculum list and the instruction that 'The Board shall promulgate regulations to implement the provisions of this section.' Both numbers are Virginia's own. The reconciliation this page offers, and labels as a reading rather than a quotation: the statute sets a floor of 120 and directs the Board to implement it, and the Board's 2021 and 2023 amendments set the operative minimum higher, at 140, with the raise phased in 'By May 12, 2023.' A reader planning a course should meet 140; a reader quoting Virginia law should not stop at the statute. The pre-clinical rule is also above the federal floor. Where federal law requires 16 hours of instruction before direct resident contact, Virginia requires 24 — and specifies what 16 of those 24 must cover: 'Prior to the direct contact with a client, a student shall have completed a total of at least 24 hours of instruction. Sixteen of those hours shall be in the following five areas: a. Communication and interpersonal skills. b. Infection control. c. Safety and emergency procedures, including dealing with obstructed airways and fall prevention. d. Promoting client independence. e. Respecting clients' rights' (18VAC90-26-40(A)(1)). Curriculum: 18VAC90-26-40 sets out twelve headings — the initial core, basic skills, personal care skills, individual client needs including mental health and social service needs, care of the cognitively or sensory impaired client, basic restorative services, clients' rights, legal and regulatory aspects of practice, occupational health and safety measures, appropriate management of conflict, observational and reporting techniques, and 'Substance abuse and opioid misuse.' Teaching ratio and staff: 'The ratio of students to each instructor shall not exceed 10 students to one instructor in all clinical areas, including the skills laboratory', and 'When students are giving direct care to clients in clinical areas, instructional personnel must be on site solely to supervise the students' (18VAC90-26-30(G)). The program coordinator or primary instructor must be a Virginia-licensed RN with two years' experience as an RN and at least one year of direct client care or supervisory experience in long-term care (18VAC90-26-30(A)), and the primary instructor 'shall not assume other duties while instructing or supervising students.' Instructors must show teaching competence by at least 12 hours of coursework or equivalent experience, and must 'complete a refresher course every three years' (18VAC90-26-30(E), (F)). Advanced certification adds a separate 120 hours on top of the basic program (18VAC90-25-110(A)(5)) — a figure that is easy to confuse with the statutory 120 above; they are different requirements at different stages.",
   "lapse_rule": "Ninety days is the line that matters. Within 90 days of expiry the certificate is renewed rather than reinstated. After 90 days it becomes a reinstatement: 'An individual whose certification has lapsed for more than 90 days shall submit the required application and renewal fee and provide: a. Verification of performance of nursing-related activities for compensation in the two years prior to the expiration date of the certificate and within the preceding two years; or b. Evidence of having repeated and passed the nurse aide state examination' (18VAC90-25-80(B)(1)). The state-linked handbook describes the same step from the candidate's side and notes who decides: 'If you were previously listed on the Virginia Board of Nursing Registry and have been lapsed for more than ninety (90) days, you must submit a reinstatement application and fees to the Board of Nursing. The Board will then determine if you also need to take the NNAAP examination to demonstrate competency for reinstatement.' The reinstatement fee is $30, the same as an annual renewal. Retesting after a lapse has its own eligibility route: E4 covers a candidate 'previously certified in Virginia as a nurse aide, but your certification E-4 has expired', requires a renewal or reinstatement application filed with the Board within the past 12 months, and gives 24 months from application approval to test. The route back is closed entirely for one group: 'An individual who has previously had a finding of abuse, neglect, or misappropriation of property is not eligible for reinstatement of his certification, except as provided in 18VAC90-25-81' — the once-only petition to remove a single-occurrence neglect finding after at least a year. A certificate suspended or revoked by the board may be reinstated, if the holder is eligible, on the same terms as a lapsed certificate (18VAC90-25-80(C)); the Board's fee table shows no separate after-discipline reinstatement fee for CNAs, though it does for every licensed profession. Note what Virginia does not do: there is no five-year cliff and no requirement to repeat the training program after a long lapse. The rule offers the examination as the alternative to documented work no matter how long the gap, which is materially more forgiving than the states that force retraining after 24 months. That reading rests on the text of 18VAC90-25-80(B) as written; the Board's discretion to require the examination is explicit in the handbook.",
   "reciprocity": "Virginia calls it endorsement and, unusually, it normally avoids the examination altogether — 'If you are a nurse aide currently listed on another state's nurse aide registry, and you are seeking certification on the Virginia Nurse Aide Registry, you may not need to test.' The five conditions, in the Board's own rule (18VAC90-25-72): the applicant shall '1. Be a graduate of a state-approved nurse aide education program that meets the requirements for clinical training and competency set forth in 42 CFR 483.152; 2. Have satisfactorily completed a competency evaluation program; 3. Be currently registered in another state, with no finding of abuse, neglect or misappropriation of property; 4. Submit the required application; and 5. Submit the required verification form to the credentialing agency in each state in which the applicant has been registered, certified, or licensed, unless electronic verification is available.' Note the reach of condition 5 — verification goes to every state the applicant has ever been registered, certified or licensed in, not just the current one. The statutory overlay adds a substantial-equivalence test and a clean-record test: the applicant must be 'certified to practice as a nurse aide by another state or territory of the United States (with requirements that are essentially similar to the requirements for certification set out in this article) and that such certification is in good standing', must not have committed a disciplinable act, and must have 'no record of abuse, negligent practice, or misappropriation of a patient's or resident's property or any disciplinary action taken or pending in any other state or territory' (Va. Code 54.1-3024). Currency is the gate: the rule says 'currently registered', so a lapsed out-of-state credential does not endorse. Timing depends on the other state, not on Virginia: 'The length of the endorsement process depends on the time it takes your state to provide verification that you are a certified nurse aide and meet requirements like those for initial certification in Virginia.' Applications are submitted online through the Board. A military credit provision sits alongside endorsement rather than inside it: 'The Board shall consider and may accept relevant practical experience and didactic and clinical components of education and training completed by an applicant for certification as a nurse aide during his service as a member of any branch of the armed forces of the United States as evidence of the satisfaction of the educational requirements for certification' (Va. Code 54.1-3023(B)) — permissive, and it satisfies the education requirement only, not the examination. Checked and not found: any endorsement fee (the Board's table shows $0 application for a CNA), any published processing time, and any nurse-aide interstate compact — the Nurse Licensure Compact Virginia belongs to covers RNs and LPNs.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Virginia Board of Nursing — Nurse Aide (the application wizard). Establishes the four candidate paths (certified in another state; first-time certification; adding Advanced Nurse Aide Certification; reinstatement), the direction to 'visit the Credentia website and schedule the Virginia Nurse Aide Competency Test (\\\"State Board\\\")', the reproduction of the advanced-certification qualifications from 18VAC90-25-110(A), the online reinstatement process and its Employment Verification Form, the Checklist Instructions for Certification by Endorsement, and the Board's mailing address.\", \"url\": \"https://www.dhp.virginia.gov/Boards/Nursing/ApplicantResources/ApplyforLicense/NurseAide/\"}, {\"label\": \"Virginia Board of Nursing — Fees. The Board's published fee table, and the source of the CNA line: Certified Nurse Aide application $0, renewal (annual) $30, reinstatement $30, duplicate CNA $0, returned check $50; Advanced Certified Nurse Aide application $25, renewal $20, reinstatement $30. Also establishes the comparison figures for RN, LPN, APRN, LMT and Registered Medication Aide, the late-renewal surcharges that exist for those credentials and not for the CNA, and the payment rule that 'Fees shall be paid by check or money order made payable to the Treasurer of Virginia ... All fees are nonrefundable.'\", \"url\": \"https://www.dhp.virginia.gov/Boards/Nursing/ApplicantResources/Fees/\"}, {\"label\": \"18VAC90-25 (Regulations Governing Certified Nurse Aides), Virginia Administrative Code, Virginia General Assembly. Establishes the fee schedule (18VAC90-25-16), the identification, name-change and 30-day address rules (-15), 'Initial certification shall be for two years' and the board's contracting and passing-standard powers (-70), the three entry routes and the two-year/three-attempt bar (-71), the five endorsement conditions (-72), annual renewal with the two-year work attestation, the 30-day notice, the retest-on-no-work rule and the 90-day reinstatement line (-80), the once-only neglect-removal petition (-81), the nurse aide unprofessional-conduct definitions (-100), and the advanced certificate's requirements and renewal (-110, -120).\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter25/\"}, {\"label\": \"18VAC90-26-50 (Other program requirements), Virginia Administrative Code. The source of the training hours: 'By May 12, 2023, the program shall be at least 140 clock hours in length, at least 20 hours of which shall be specifically designated for skills acquisition in the laboratory setting. The program shall provide for at least 24 hours of instruction prior to direct contact of a student with a client. Clinical training in clinical settings shall be at least 40 hours of providing direct client care. Hours of observation shall not be included in the required 40 hours of clinical training. Time spent in employment orientation to facilities used in the education program must not be included in the 140 hours allotted for the program.' Also establishes the student-badge rule, the skills record and certificate of completion, and the requirement to keep NNAAP pass-rate records.\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter26/section50/\"}, {\"label\": \"18VAC90-26-40 (Requirements for the curriculum) and 18VAC90-26-30 (Requirements for instructional personnel), Virginia Administrative Code. Establish the 24-hour pre-clinical block and the 16 hours of it that must cover communication and interpersonal skills, infection control, safety and emergency procedures, promoting client independence and respecting clients' rights; the twelve curriculum headings including substance abuse and opioid misuse; the RN program-coordinator and primary-instructor qualifications; the rule that the primary instructor 'shall not assume other duties while instructing or supervising students'; the 12-hour teaching-competence requirement and the three-year refresher; and the 10:1 clinical and skills-laboratory ratio with instructional personnel 'on site solely to supervise the students'.\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter26/section40/\"}, {\"label\": \"18VAC90-26-20 (Establishing and maintaining a nurse aide education program), Virginia Administrative Code. Establishes the 90-day advance application, the site visit before approval, the 42 CFR 483.151(b)(2) clinical-setting penalty bar, the 50-mile clinical-site approval rule, the no-fee rule for students who are employed or hold an offer when the program begins, the duty to give each student the barrier-crimes information, and the 10-day reporting of substantive program changes.\", \"url\": \"https://law.lis.virginia.gov/admincode/title18/agency90/chapter26/section20/\"}, {\"label\": \"Code of Virginia 54.1-3028.1 (Nurse aide education programs). The statutory program-length minimum that sits below the Board's regulation: 'Nurse aide education programs designed to prepare nurse aides for certification shall be a minimum of 120 clock hours in length', with a curriculum list and the direction that 'The Board shall promulgate regulations to implement the provisions of this section.' Enacted 1999 c. 783; amended 2016 cc. 109, 582.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/section54.1-3028.1/\"}, {\"label\": \"Code of Virginia 54.1-3022, 54.1-3023, 54.1-3024, 54.1-3025, 54.1-3025.1, 54.1-3026, 54.1-3027 and 54.1-3028. Establish respectively: the title protection for 'Certified Nurse Aide' and 'C.N.A.'; the application requirements and the Board's discretion to accept armed-forces training as satisfying the education requirement; the endorsement requirements including 'requirements that are essentially similar' and the no-abuse-record condition; the five statutory subject areas of the clinical competency evaluation; the advanced certificate and its biennial renewal clause; 'Each certificate issued to practice as a nurse aide shall be renewed annually'; the two exclusions for gratuitous care of friends or family and for a person for hire who does not hold out as a CNA; and the pre-October-1989 registry grandfather.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/section54.1-3026/\"}, {\"label\": \"Code of Virginia 54.1-3007 (Refusal, revocation or suspension, censure or probation). The eight statutory grounds, including 'Conviction of any felony or any misdemeanor involving moral turpitude', 'The denial, revocation, suspension or restriction of a license, certificate, registration, or multistate licensure privilege to practice in another state', and 'Abuse, negligent practice, or misappropriation of a patient's or resident's property.'\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/section54.1-3007/\"}, {\"label\": \"Code of Virginia 54.1-3005.1 (Criminal history background checks). Cited for its limits: the Board must fingerprint applicants 'for licensure as a practical nurse, registered nurse, or licensed massage therapist' — nurse aides are not included, which is why this page states that Virginia does not fingerprint nurse aide applicants.\", \"url\": \"https://law.lis.virginia.gov/vacode/title54.1/chapter30/section54.1-3005.1/\"}, {\"label\": \"Virginia Board of Nursing — Nurse Aide Education Programs. Establishes the Board's ownership of program approval ('the Virginia Board of Nursing does not regulate nor approve out of state or post licensure nurse aide education programs'), the Board Approved Curriculum, the Application to Establish a Nurse Aide Education Program and the Advanced Certification Program application, the clinical-site and primary-instructor exception request forms, the Virginia Skills Listing, the link to Credentia, the link to 42 CFR 483.152 as the federal program-approval requirement, and the statement that NNAAP pass rates are published on the Board's Testing Pass Rates page.\", \"url\": \"https://www.dhp.virginia.gov/Boards/Nursing/EducationPrograms/EstablishingMaintainingEducationPrograms/NurseAideEducationPrograms/\"}, {\"label\": \"Virginia Nurse Aide Candidate Handbook (NNAAP) — Quick Reference, the handbook the Board directs candidates to through its Nurse Aide application page and its education-programs page. The handbook is published as separate articles and the four that carry the facts used here are cited individually below (Exam Overview, Exam Fees, Eligibility Criteria and The Registry). Establishes the two-part examination and its question counts (70 written; 60 plus 10 oral; five randomly selected skills rated by a Nurse Evaluator), the exam fees ($45 written only, $45 oral only, $95 skills only, both required at the first sitting, non-refundable, payable by card or voucher), 'Under federal and Virginia laws, nursing homes are required to pay the NNAAP fees for their nurse aide employees', the age-16 requirement, the light-duty bar on the Skills Evaluation, the January 30 2024 eligibility-route change and routes E1 through E4, the 60-day renewal notice, the two-year work attestation and the retest consequence, the 90-day lapse rule, and the endorsement description.\", \"url\": \"https://kb-va.credentia.com/en/article/quick-reference\"}, {\"label\": \"Virginia Nurse Aide Candidate Handbook — Exam Overview. Establishes the written examination's size and language ('The written part of the test is comprised of seventy (70) multiple-choice questions written in English'), the oral alternative ('The Oral Examination includes sixty (60) multiple-choice questions and ten (10) reading comprehension/word recognition questions'), the skills evaluation ('For the Skills portion test, you will be asked to perform five (5) randomly selected nurse aide skills'), and the requirement to request the oral form at registration.\", \"url\": \"https://kb-va.credentia.com/en/article/exam-overview\"}, {\"label\": \"Virginia Nurse Aide Candidate Handbook — Exam Fees. Establishes the fee table ('Written Examination Only $45 / Oral Examination Only $45 / Skills Examination Only $95'), the both-parts-at-first-sitting rule ('You must pay for both the Skills Evaluation and the Written (or Oral) Examination the first time you test'), the employer-pays rule ('Under federal and Virginia laws, nursing homes are required to pay the NNAAP® fees for their nurse aide employees, including individuals required to retest') and 'Fees are not refundable'.\", \"url\": \"https://kb-va.credentia.com/en/article/exam-fees\"}, {\"label\": \"Virginia Nurse Aide Candidate Handbook — Eligibility Criteria. Establishes the age statement ('To be a nurse aide in Virginia, you must be sixteen (16) years of age or older'), which appears nowhere in Virginia's statutes or regulations and is attributed to the handbook wherever this page uses it; the light-duty bar on the Skills Evaluation with 'THERE ARE NO EXCEPTIONS TO THIS RULE'; 'Both exams must be passed under the same application'; and the eligibility routes including the previously-certified route E4.\", \"url\": \"https://kb-va.credentia.com/en/article/eligibility-criteria\"}, {\"label\": \"Virginia Nurse Aide Candidate Handbook — The Registry. Establishes the two-year first term ('Your initial nurse aide certification is valid for two (2) years'), the 60-day renewal notice ('At least sixty (60) days prior to the expiration date of your certificate, a renewal notice will be mailed'), the reinstatement paragraph for a certificate 'lapsed for more than ninety (90) days', and the endorsement statement that an applicant 'MAY NOT need to test'.\", \"url\": \"https://kb-va.credentia.com/en/article/the-registry\"}, {\"label\": \"Credentia — Virginia Test Takers, the page the Virginia Board of Nursing links by name from its Nurse Aide application page. Establishes the registration sequence for the NNAAP Nurse Aide Exam, the link to the Virginia handbook, the Credentia Platform account requirement, the note that former Pearson VUE account holders must create a new account, the Virginia skills listing and accommodations forms, the voucher guides for training programs and sponsors, and its own link back to the Virginia nurse aide registry lookup.\", \"url\": \"https://www.credentia.com/test-takers/va\"}, {\"label\": \"Virginia Department of Health Professions — License Lookup. The public verification tool, and the source of the search fields listed under Verify a license on this page (license number; last four of SSN plus last name; occupation, with Certified Nurse Aide and Advanced Certified Nurse Aide listed separately; name; state; ZIP; status). Also establishes 'This serves as primary source verification of the credential issued by the Commonwealth of Virginia and meets the requirements of the Joint Commission', the coverage of expired records back to January 1, 2000, and the anti-bulk-use throttle.\", \"url\": \"https://dhp.virginiainteractive.org/Lookup/Index\"}, {\"label\": \"Virginia Board of Nursing — Employment Verification Form, Certified Nurse Aide (revised January 21, 2026, PDF). The form used to document nursing-related employment for renewal or reinstatement: employer name and physical address, start and end employment dates, role or job held, CNA certificate number, applicant attestation, and the reinstatement reason (expired, after discipline, or reinstatement after mandatory suspension). Returned to nurseaide@dhp.virginia.gov.\", \"url\": \"https://www.dhp.virginia.gov/media/dhpweb/docs/nursing/forms/Employment_Verification.pdf\"}]",
   "page_url": "https://licensingatlas.com/cna/va-cna/"
  },
  {
   "page_id": "vt-cna",
   "state": "Vermont",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Vermont State Board of Nursing, within the Office of Professional Regulation (OPR) in the Office of the Vermont Secretary of State — 'The Vermont State Board of Nursing, together with the Secretary of State's Office of Professional Regulation (OPR), provide governance, oversight and enforcement for your profession.' The Board issues the license. A second agency owns the training and testing side: the Department of Disabilities, Aging, and Independent Living (DAIL), through its Division of Licensing and Protection (DLP), approves the Nurse Aide Training and Competency Evaluation Program and approves the competency examination (Board rule 10-1; 26 V.S.A. 1645(c)(1)).",
   "board_url": "https://sos.vermont.gov/nursing/",
   "application_url": "https://sos.vermont.gov/nursing/apply-renew",
   "renewal_cycle": "Biennially, on a fixed statewide date rather than on the anniversary of your license: LNA licenses expire on 'November 30th of Even Years' (OPR fee and renewal-date chart). 'Licenses are valid for fixed, two-year periods. Expiration dates are printed on licenses. A license expires if not renewed by midnight on the date of expiry. Practice under an expired license is prohibited' (Rule 4-3). What you must show — paid-or-unpaid practice, not coursework. Rule 4-8(b): 'LNAs shall demonstrate, via job description or other appropriate employer verification, at least 50 days (400 hours), in the two years preceding application, of employment as a nurse assistant or in a role, regardless of title or obligation to hold a license, that would reasonably tend to reinforce the training and skills of a licensed nurse assistant.' The statute writes the same generosity into law: 'The Board shall credit as ongoing practice those activities, regardless of title or obligation to hold a license, that reasonably tend to reinforce the training and skills of a licensee' (26 V.S.A. 1645(b)). OPR spells out how to document work that was not itself LNA work: 'A licensee who has worked in a position that does not require LNA licensure but reinforces the knowledge and skills of an LNA must upload into their renewal application ... A copy of their job description that details essential functions of the position; and Employer verification of dates of employment and hours worked on company letterhead.' How it runs: 'Renewal applications open six weeks before the expiration date and are submitted through the Online Services System', with 'Courtesy email reminders' — but 'non-receipt of such reminders shall not excuse a licensee from the obligation to maintain continuous licensure or the consequences of failing to do so' (Rule 4-7), and OPR repeats that 'It is solely the licensee's responsibility to know the date their license expires.' Proof is attested, then audited: 'The current practice is that you will not be asked to upload a verification letter at the time of renewal. However, you may be selected in an audit, at which time you will need to obtain a letter verifying your practice hours ... 30 days after the renewal period ends, OPR conducts an audit. A percentage of licensees are chosen at random.' An expired licensee renewing must also complete the criminal background check — a 'requirement as of 9/1/2022' — but 'License renewal will not be delayed by pending criminal background checks.' Processing takes 3-5 business days.",
   "ce_hours": "None for the LNA license. Vermont's renewal condition is practice, not education: the statute says only that 'To renew a license, a nursing assistant shall meet ongoing practice requirements set by the Board by rule' (26 V.S.A. 1645(a)), and the rule that supplies those requirements asks for 50 days (400 hours) of qualifying work in the preceding two years and nothing else (Rule 4-8(b)). The contrast inside the same rule is the proof: for RNs and LPNs, Rule 4-8(a) offers continuing education as an alternative to practice hours — '20 hours of qualifying continuing education in the two years immediately preceding the application' — and for APRNs and MNAs the rule adds further requirements. LNAs get neither the alternative nor an obligation. Continuing education does attach to the medication specialty, and only there. Rule 4-8(c): 'MNAs shall: (1) Have satisfied LNA renewal requirements; (2) Have completed 4 hours qualifying continuing education specific to medication administration; and (3) Have dedicated at least 25% of the qualifying LNA experience (100 hours) to MNA functions.' OPR describes the subject matter it will accept for that specialty on the Secretary of State's nursing apply-and-renew page, under the MNA renewals heading 'Continuing Education Information': 'Continuing education hours will be accepted from accredited Continuing Education providers or programs on topics related to medication administration, medication safety, medication documentation, and medication error prevention.' The same block notes that such courses may come from an employer's accredited programs or online. Sources checked and confirming no LNA continuing-education requirement: 26 V.S.A. chapter 28 subchapter 4 in full (sections 1641 through 1646), 26 V.S.A. 1577, the Administrative Rules of the Vermont Board of Nursing (May 11, 2023) Parts 4 and 10 in full, the OPR LNA Renewal Instructions (March 2026), and the Secretary of State's nursing FAQ.",
   "exam": "Two parts, both required, and you must be cleared by OPR before you can sit them. 'The Competency Exam includes two parts: a written test and a skills test. You need to pass both sections in order to obtain your license.' Registration: candidates book a date through the testing provider's schedule and pay at the end — 'your seat is NOT reserved until your payment is received' — then upload the Authorization to Test letter from the Office of Professional Regulation to the testing portal. 'You will be registering for 2 tests: Written Test and Skills Test for combined exam fees of $200.' Attempts — three, then back to school: 'A candidate who has not passed LNA exams after three attempts must repeat an approved nursing assistant education program' (Board rule 10-2). Results go to the candidate, the training program coordinator, DAIL's Division of Licensing and Protection and OPR. Study material the provider publishes: a Nurse Aide Competency Test Guide and an MNA Competency Test Guide, plus commercially sold sample-question sets that are not part of the examination. What Vermont does not publish, checked across the Secretary of State's nursing pages, the Board's administrative rules, DAIL's NATCEP page and the testing provider's LNA pages: a question count, a time allowance, a passing score, or the number of skills demonstrated. Those figures are in the provider's test guide rather than in any state rule, so this page states none of them. Note that the examination is also the re-entry mechanism, not just an entry one — a lapsed licensee returning after fewer than five years away must 'repeat and pass the competency examinations approved by the Department of Disabilities, Aging, and Independent Living before licensure renewal' (26 V.S.A. 1645(c)(1)), and the provider offers the same competency exam 'for those who currently hold an inactive or expired Vermont LNA License.'",
   "fees": "State fees are set by statute, and they are among the lowest for any Vermont profession. 26 V.S.A. 1577: 'Applicants and persons regulated under this chapter shall pay the following fees: (1) Nursing Assistants (A) Application $25.00 (B) Biennial renewal $65.00.' OPR's published fee chart matches exactly — '075 - Licensed Nursing Assistant' with a $65 renewal fee, a $25 application fee, and a renewal date of 'November 30th of Even Years' — and the chart explains where the numbers come from: 'Regulatory fees are established by the Legislature and listed in the Vermont Statutes ... Board profession fees can be found within each profession's chapter in 26 V.S.A.' Note the direction of the two figures: renewing costs more than applying. Both application and renewal fees are non-refundable. Late renewal is the expensive part, and it escalates monthly. 3 V.S.A. 127(d)(1): a person whose license has expired for not more than one biennial period may reinstate 'by meeting renewal requirements for the profession, paying the profession's renewal fee, and paying the following nondisciplinary reinstatement penalty: (A) if reinstatement occurs within 30 days after the expiration date, $100.00; or (B) if reinstatement occurs more than 30 days after the expiration date, an amount equal to the renewal fee increased by $40.00 for every additional month or fraction of a month, provided the total penalty shall not exceed $1,500.00.' Relief is possible but narrow: 'A licensee seeking reinstatement may submit a petition for relief from the reinstatement penalty, which a board may grant only upon a finding of exceptional circumstances or extreme hardship', and no penalty is assessed 'for any period during which a licensee was a member of the U.S. Armed Forces on active duty.' OPR states the practical version: 'Any penalties associated with your late renewal will need to be paid in order for your license to be renewed. You may contact the renewal clerk if you wish to receive the form to request relief from the reinstatement penalty.' Verification to another state, from the Secretary of State's nursing apply-and-renew page under 'Verification of Licensure — From OPR to another licensing authority': 'Please log in to your online services account to request a verification of licensure. There is a $20 fee. OPR offers official online verification at no cost at Find a Professional.' The same page adds that the paper forms it publishes 'can be used but are not required', that 'Every state is different, please contact the receiving state', and that 'Verifications are processed within 5 business days.' Not a state fee: the examination. The testing provider charges '$200' for the written and skills tests together, and the Board's fee statute contains no examination fee. Not set by the state: tuition for the nursing assistant education program. And see the reimbursement rule above — for an LNA employed by a federally certified nursing facility, the testing cost is reimbursed by DAIL and the training cost falls on the facility or on the State, though 'Neither the State nor the nursing facility is responsible for reimbursing an individual for licensure expenses.' A no-initial-renewal rule softens the first cycle: 'An applicant issued an initial license within 90 days of the end of a licensing period will not be required to renew or pay the renewal fee. The license will be issued through the next full licensure period' (Rule 4-4).",
   "legal_basis": "[{\"citation\": \"26 V.S.A. chapter 28, subchapter 4 (Nursing Assistants) — sections 1641 (Definitions), 1642 (Nursing assistant licensure by examination), 1643 (Nursing assistant licensure by endorsement), 1644 (Prohibitions; offenses), 1645 (Renewal) and 1646 (Exemptions), all added by 2015, No. 38, sec. 14, eff. May 28, 2015\", \"what_it_governs\": \"The license itself: what a nursing assistant and a medication nursing assistant are, the three statutory elements of licensure by examination (age 16, an approved education program, the competency examination), endorsement including the mandatory military-medic route, the title and practice prohibitions and their penalties, the ongoing-practice renewal standard and the re-examination duty after a lapse, and the three exemptions. Section 1645 is the most recently amended, by 2023, No. 158 (Adj. Sess.), sec. 9, eff. June 6, 2024 and 2025, No. 58, sec. 8, eff. July 1, 2025.\", \"url\": \"https://legislature.vermont.gov/statutes/chapter/26/028\"}, {\"citation\": \"26 V.S.A. 1577 (Fees), as amended by 2023, No. 77, sec. 27, eff. June 20, 2023\", \"what_it_governs\": \"The statutory fee schedule for the whole nursing chapter, including the only two state fees an LNA pays: 'Nursing Assistants (A) Application $25.00 (B) Biennial renewal $65.00.'\", \"url\": \"https://legislature.vermont.gov/statutes/section/26/028/01577\"}, {\"citation\": \"26 V.S.A. 1572 (Definitions)\", \"what_it_governs\": \"The chapter-wide definitions, including the one that settles what kind of credential this is: 'License means a current authorization permitting the practice of nursing as a registered nurse, licensed practical nurse, or advanced practice registered nurse, or the practice as a nursing assistant.'\", \"url\": \"https://legislature.vermont.gov/statutes/section/26/028/01572\"}, {\"citation\": \"Administrative Rules of the Vermont Board of Nursing, May 11, 2023 — Part 4 (Licensure Generally, rules 4-1 to 4-10) and Part 10 (Licensed Nurse Assistants, rules 10-1 to 10-14)\", \"what_it_governs\": \"The operative detail the statute delegates: the two-year currency of the education program and its DAIL approval, the federal criminal background check, the three-attempt examination limit, the endorsement practice requirement of 50 days (400 hours), Fast Track Endorsement, the fixed two-year licensing period, provisional licensure, the renewal practice requirement, late-renewal penalties and the two-to-five-year and over-five-year reinstatement ladder, the LNA scope of practice and its exclusions, and the entire Medication Nursing Assistant specialty including its 60-hour classroom plus 40-hour clinical training standard.\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/nursing/nursing_administrative_rules.pdf\"}, {\"citation\": \"3 V.S.A. 127 (Unauthorized practice), as amended by 2025, No. 58, sec. 5, eff. July 1, 2025; and 3 V.S.A. 130 (provisional licensure) and 3 V.S.A. 136a (expedited endorsement), as cited by the Board's rules\", \"what_it_governs\": \"Section 127 supplies the penalties that 26 V.S.A. 1644(c) points to — a civil penalty of up to $5,000 for unauthorised practice, criminal exposure of up to $5,000 or a year's imprisonment, and the escalating nondisciplinary reinstatement penalty of $100 within 30 days or the renewal fee plus $40 per additional month capped at $1,500 — plus the rule that practising more than two years on an expired license may be prosecuted as unauthorised practice. Sections 130 and 136a are named by Board rules 4-5 and 4-1 as the authority for the 90-day provisional license and for Fast Track Endorsement; their own texts were not read as of August 16, 2026, and nothing on this page rests on them beyond the rules' own descriptions.\", \"url\": \"https://legislature.vermont.gov/statutes/section/03/005/00127\"}, {\"citation\": \"42 CFR Part 483, Subpart D — Requirements for States and State Agencies: Nurse Aide Training and Competency Evaluation, and Paid Feeding Assistants (42 CFR 483.150-.158)\", \"what_it_governs\": \"The federal frame Vermont's training and testing side implements. DAIL's Division of Licensing and Protection directs program applicants to it rather than to a separate state hour rule, stating that 'Federal and State regulations and program requirements included in the Federal NATCEP Resource' and that applicants 'declare in initial application to read and implement Federal of NATCEP Resource requirements', that 'Federal law allows up to 90 days for approval of a completed application', and that a nursing-home-based program is barred for two years after an extended survey, a nurse-staffing waiver, a civil money penalty or a denial of payment. The federal text itself was not read as of August 16, 2026; it is cited because Vermont's own program page rests on it.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "Excel Testing, LLC — and the state's own materials do not all agree on this, so both readings are recorded. What the two agencies link: DAIL's Division of Licensing and Protection links exceltestingvt.com from its NATCEP page under the heading 'Vermont Nurse Aide Testing', and the Secretary of State's own Nursing Applications and Renewals page lists 'Excel Testing Service' as the Examination Information for Licensed Nursing Assistants and 'Excel Testing MNA Testing in Vermont' for the medication specialty. Excel describes itself in matching terms: 'Our tests meet all federal guidelines and Excel Testing is an approved testing provider for Vermont', and 'We pride ourselves on our timely and accurate score reporting to not only candidates but to their program Coordinators and the Division of Licensing and Protection Department of Disabilities, Aging and Independent Living, along with the Vermont Office of Professional regulation as requested.' What the other official document says: the Secretary of State's own LNA Application Instructions (February 2026) describe a different examination — 'you will be issued a formal authorization to take the national Nurse Aide Assessment Program (NNAAP) written and skills exams.' The NNAAP is a national vendor programme, not Excel's Vermont examination. Both statements are Vermont's; this page reports both and resolves neither. A reader should treat the Authorization to Test letter and the testing provider that OPR and DLP link as the operative pair, and should expect the NNAAP name to appear on the instruction sheet. The legal standard behind either name is agency approval, not a vendor: the Board licenses an applicant who has passed 'a competency examination approved by the Department of Disabilities, Aging, and Independent Living or an equivalent exam acceptable to the Board' (Rule 10-1(c)), and the statute names the same department for re-examination after a lapse (26 V.S.A. 1645(c)(1)).",
   "training_hours": "75 clock hours total, split as at least 59 hours of curriculum instruction and 16 hours of supervised practical training. The figures come from the agency that approves the programs — DAIL's Division of Licensing and Protection, on its Nurse Aide Training Competency Evaluation Program page: 'An approved nurse aide training and competency evaluation program must be at least 75 clock hours in length. Training includes at least 59 hours of curriculum instruction and 16 hours of supervised practical training with a live person in a laboratory or another setting. Location of or method of curriculum instruction and supervised practical training identified in application packet.' Two things to notice. First, Vermont sits exactly on the federal floor rather than above it — 75 hours is the OBRA minimum, and the 16 supervised hours track the federal requirement for supervised practical training; DLP directs program applicants to the federal materials rather than to a separate state hour rule, stating that 'Federal and State regulations and program requirements included in the Federal NATCEP Resource' and that applicants 'declare in initial application to read and implement Federal of NATCEP Resource requirements.' Second, Vermont does not require the practical hours to be worked in a nursing home — the rule as published permits 'a live person in a laboratory or another setting', which is looser than the facility-clinical mandate several states impose. The license adds a freshness clock the hours themselves do not: the program must have been 'completed, within two years of application' (Board rule 10-1(a)). Curriculum content is set on the Board side rather than by hour count — the Board's LNA position statement lists nine required subject areas: 'Basic Nursing Care; Personal Care; Basic Restorative Care; Psychosocial Skills; Care of the Cognitively Impaired; Communication Skills; Ethics and legal responsibilities; Teamwork; and Patient Safety.' Who may run a program: the administrator must be a 'Vermont RN with a minimum of two years of licensed nursing experience' including 'at least one year in the provision of long-term care facility services in the US', and DLP is explicit that 'Licensed nursing experience does not include nurse aide' and that 'Home health experience providing care in private homes only is not included.' A nursing-home-based program is barred if the home 'ha[s] had an extended or partial extended survey, operated with a waiver of the 8 hour per day registered nurse requirement, been assessed a civil money penalty, or had a denial of payment enforced within past two (2) years', subject to a NATCEP prohibition waiver. DLP notes that 'Federal law allows up to 90 days for approval of a completed application.'",
   "lapse_rule": "Vermont's answer depends on how long you have been away from practice, not only on how long the license has been expired — and its three official statements of the rule do not fully agree, so all three are recorded. The statute, most recently amended effective July 1, 2025. 26 V.S.A. 1645(c): '(1) A licensee seeking to renew an expired or lapsed license after fewer than five years of absence from practice shall repeat and pass the competency examinations approved by the Department of Disabilities, Aging, and Independent Living before licensure renewal. (2) A licensee who does not pass the competency examinations shall repeat a nursing assistant education program and competency examination.' OPR'S current instruction sheet (LNA Renewal Instructions, March 2026) draws the same five-year line but adds the education program at the far end: 'A licensee who does not meet active practice requirements whose license has been lapsed for fewer than five years must take and pass the LNA skills and written examinations to renew their license. A licensee who does not meet the active practice requirement and whose license has been lapsed for five years or more shall repeat a nursing assistant education program and pass the skills and written examinations to renew their license.' The Board's rule, dated May 11 2023 and therefore older than both, states it flatly and more harshly, with no five-year distinction at all: 'A licensee who does not meet the active practice requirement shall repeat the nursing assistant education program and competency examination' (Rule 4-8(b)(1)). The testing provider's reinstatement page reproduces that rule verbatim, so a candidate can meet the strict version and the lenient version on the same afternoon. A reader in this position should ask OPR which applies to them before enrolling in anything. The reinstatement ladder, separate from the practice question. Rule 4-10: 'A license expired for more than two years requires reinstatement, including a federal criminal background check. (a) Two to five years. A license expired for two to five years may be reinstated upon proof of continuous practice elsewhere, or if practice ceased, upon satisfaction of the requirements of renewal set out in Rule 4-8. (b) More than five years. A license expired for five or more years may be reinstated upon proof of continuous practice elsewhere, or if practice ceased, a licensee's preparation to return to practice will be assessed on a case-by-case basis. After consultation with the Board, the Director may require re-training, testing, or re-application. See 3 V.S.A. § 135. In most circumstances, completion of an approved nursing re-entry program is a minimum prerequisite to reinstatement.' That last sentence changes the reading of the one before it: the Director 'may' require re-training, but the rule then makes an approved nursing re-entry program the normal floor for a license expired five years or more. An ambiguity the rule does not resolve, recorded rather than guessed: 'approved nursing re-entry program' is defined in the same rules only for practical nurses (Rule 5-16) and registered nurses (Rule 5-18), and no re-entry program is defined for nursing assistants anywhere in Parts 5 or 10. Whether the sentence reaches an LNA at all is therefore unclear from the rule's own text, and this page does not decide it. Money: the escalating reinstatement penalty in 3 V.S.A. 127(d) — $100 within 30 days, then the renewal fee plus $40 per additional month or part month, capped at $1,500 — applies to a license expired for not more than one biennial period. Practising while lapsed is not a fee problem: 'Practicing while a license is lapsed is a violation of 3 V.S.A. 127' (Rule 4-7), and 'Practice by a licensee with an expired license that continues for more than two years, or practicing at any time when the licensee knew or should have known the license was expired, may be prosecuted by the State as unauthorized practice ... or as unprofessional conduct' (3 V.S.A. 127(d)(4)). Unauthorised practice carries 'a civil penalty of not more than $5,000.00' and, criminally, 'a fine of not more than $5,000.00 or imprisonment for not more than one year, or both' (3 V.S.A. 127(b)-(c)). The route back to the examination runs through OPR, not the testing centre: 'Individuals looking to reinstate their license MUST have received an Authorization to Test letter from the Vermont Office of Professional Regulation.'",
   "reciprocity": "Vermont calls it endorsement, offers two speeds of it, and adds a mandatory-issue route for military medics. Ordinary endorsement is for someone licensed elsewhere who cannot show three years. The statute delegates the standard — the Board may license an applicant who 'is licensed or registered in another U.S. jurisdiction' and 'has met the practice requirements set by the Board by rule' (26 V.S.A. 1643(a)) — and the rule sets three conditions: be 'licensed or certified as nursing assistant by another state'; 'complete a federal criminal background check'; and 'demonstrate, via job description or other appropriate employer verification, at least 50 days (400 hours), in the two years preceding application, of employment as a nurse assistant or in a role, regardless of title or obligation to hold a license, that would reasonably tend to reinforce the training and skills of a licensed nurse assistant' (Rule 10-3). OPR adds the paperwork: 'Verification of your licensure submitted from your original state of licensure and from your most recent state of licensure, if different.' Fast track endorsement is the three-year lane: 'An applicant with three or more years of full-time licensed practice, as an LNA, LPN, RN, or APRN, in good standing, in a U.S. jurisdiction outside Vermont, may qualify for expedited licensure in Vermont. See 3 V.S.A. 136a' (Rule 4-1). It asks for continuous licensure in good standing for the three years preceding the application and drops the 50-days employment demonstration. The military route is not discretionary: 'the Board SHALL issue a license' to a service member or recent veteran designated as a 68W Combat Medic Specialist or equivalent and certified as a National Registry Emergency Medical Technician (26 V.S.A. 1643(b)) — this is a license for a qualification that is not a nursing assistant credential at all. There is no nursing-assistant compact. Vermont belongs to the Nurse Licensure Compact, but the Compact covers RNs and LPNs only; nothing in 26 V.S.A. chapter 28 subchapter 5, the Board's Part 8, or OPR's Nurse Licensure Compact material extends multistate privileges to nursing assistants, so an out-of-state nursing assistant needs a Vermont license. The equivalence standard Vermont applies to an out-of-state credential, in OPR's words: 'an applicant must be licensed or certified in good standing in another state or jurisdiction in which the standards and qualifications required for LNA licensure in that jurisdiction are substantially equivalent to Vermont's.' Checked and not published: any separate endorsement fee (26 V.S.A. 1577 sets one nursing assistant application fee of $25 with no endorsement variant, unlike the practical-nurse and registered-nurse entries which price examination and endorsement differently), and any processing time for endorsement beyond the general 'minimum of 5 full business days'.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Vermont Secretary of State, Office of Professional Regulation — Nursing Applications & Renewals. Establishes the LNA application and renewal pathways and their forms, 'Fingerprint-supported background checks are required for nursing licensure in Vermont', the 90-day provisional license and its once-per-applicant limit, Fast Track Endorsement, the 'minimum of 5 full business days' processing time, 'Renewal applications open 6 weeks prior to the expiration', the heading 'Out of State Licensed Nursing Assistants (LNA aka CNA)', 'Excel Testing Service' as the LNA examination information, the Medication Nursing Assistant prerequisite that 'MNAs must hold an active LNA license in order to apply', the MNA continuing-education subject matter, and the $20 fee for a verification of licensure sent to another licensing authority.\", \"url\": \"https://sos.vermont.gov/nursing/apply-renew\"}, {\"label\": \"Vermont Secretary of State, Office of Professional Regulation — Licensed Nursing Assistant Application Instructions (February 2026, PDF). Establishes the three application types (examination, endorsement, Fast Track Endorsement), the Verification of Education requirement for out-of-state and nursing-student applicants, the 50 days (400 hours) in two years for endorsement, the military 68W/NREMT uploads, the full criminal-background-check mechanics including the Fingerprint Authorization Certificate, the FD-258 ink-print requirement for out-of-state applicants, 'Once VCIC receives your information, it can take 12 weeks for OPR to receive results', the provisional-license conditions under 3 V.S.A. 130, and the statement — stated as a conflict under the exam vendor — that a successful applicant 'will be issued a formal authorization to take the national Nurse Aide Assessment Program (NNAAP) written and skills exams.'\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/nursing/nursing_licensed_assistant_application_instructions.pdf\"}, {\"label\": \"Vermont Secretary of State, Office of Professional Regulation — LNA Renewal Instructions (March 2026, PDF). Establishes that renewals open six weeks before expiry, the 50 days (400 hours) active-practice requirement, the documents required when the qualifying work was not itself LNA work (job description plus employer verification on company letterhead), the five-year split on re-entry ('lapsed for fewer than five years must take and pass the LNA skills and written examinations'; 'lapsed for five years or more shall repeat a nursing assistant education program and pass the skills and written examinations'), that only MNAs complete continuing education, the criminal background check for expired licensees as a 'requirement as of 9/1/2022', the VCIC mailing address, and 'License renewal will not be delayed by pending criminal background checks.'\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/nursing/nursing_licensed_assistant_renewal_instructions.pdf\"}, {\"label\": \"Administrative Rules of the Vermont Board of Nursing, May 11, 2023 (PDF). Part 10 establishes the LNA licensure conditions (DAIL-approved program completed within two years, federal criminal background check, DAIL-approved competency examination), the three-attempt rule, the endorsement practice requirement, the seven-element LNA scope of practice and its exclusions, and the whole MNA specialty including its eligibility thresholds and its 60-hour classroom plus 40-hour clinical training standard. Part 4 establishes Fast Track Endorsement, the fixed two-year licensing period, the initial-license 90-day rule, provisional licensure, the renewal requirements for each credential type, late-renewal penalties, and the two-to-five-year and over-five-year reinstatement ladder.\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/nursing/nursing_administrative_rules.pdf\"}, {\"label\": \"Vermont Statutes Online — 26 V.S.A. chapter 28 (Nursing), the chapter the Secretary of State links from its own Statutes, Rules & Resources page as the Nursing Statutes. Subchapter 4 supplies sections 1641-1646 on nursing assistants; section 1572 supplies the definition of 'License'; section 1577 supplies the fee schedule.\", \"url\": \"https://legislature.vermont.gov/statutes/chapter/26/028\"}, {\"label\": \"Vermont Statutes Online — 26 V.S.A. 1642, 1643, 1644, 1645 and 1646. Establish respectively: licensure by examination at age 16 with an approved program and the competency examination; licensure by endorsement and the mandatory military-medic route; the title and practice prohibitions and their referral to 3 V.S.A. 127; the ongoing-practice renewal standard, the credit for activities 'regardless of title or obligation to hold a license', and the fewer-than-five-years re-examination duty naming the Department of Disabilities, Aging, and Independent Living; and the three exemptions.\", \"url\": \"https://legislature.vermont.gov/statutes/section/26/028/01645\"}, {\"label\": \"Vermont Statutes Online — 3 V.S.A. 127 (Unauthorized practice). Establishes the $5,000 civil penalty, the criminal exposure, and the reinstatement penalty schedule: '$100.00' within 30 days of expiry, otherwise 'an amount equal to the renewal fee increased by $40.00 for every additional month or fraction of a month, provided the total penalty shall not exceed $1,500.00', with relief only 'upon a finding of exceptional circumstances or extreme hardship' and no penalty for periods of active-duty military service.\", \"url\": \"https://legislature.vermont.gov/statutes/section/03/005/00127\"}, {\"label\": \"Vermont Office of Professional Regulation — OPR Initial Licensing/Renewal Fees & Dates and 90 Day Initial Licensing Policy (updated 7/1/2025, PDF). Establishes the LNA line of the fee chart — '075 - Licensed Nursing Assistant', renewal fee $65, application fee $25, renewal date 'November 30th of Even Years' — and the source of the numbers: 'Regulatory fees are established by the Legislature and listed in the Vermont Statutes ... Board profession fees can be found within each profession's chapter in 26 V.S.A.'\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/general/initial_licensing_renewal_fees_dates_90-day_licensing_policy.pdf\"}, {\"label\": \"Vermont Department of Disabilities, Aging and Independent Living, Division of Licensing and Protection — Nurse Aide Training Competency Evaluation Program (NATCEP). The source of the training hours: 'An approved nurse aide training and competency evaluation program must be at least 75 clock hours in length. Training includes at least 59 hours of curriculum instruction and 16 hours of supervised practical training with a live person in a laboratory or another setting.' Also establishes the program administrator qualifications ('Vermont RN with a minimum of two years of licensed nursing experience', at least one year in US long-term care, 'Licensed nursing experience does not include nurse aide'), the two-year bar on nursing-home-based programs after an extended survey, staffing waiver, civil money penalty or denial of payment, the 90-day federal approval window, and the link to the Vermont nurse aide testing provider.\", \"url\": \"https://dlp.vermont.gov/survey-cert/natcep-forms\"}, {\"label\": \"Vermont DAIL, Division of Licensing and Protection — Nurse Aide Training and Testing Reimbursement Procedures (revised and approved 7/6/17, PDF). Establishes that LNAs employed by a federally certified nursing facility 'are not responsible to pay for LNA training and testing costs', that 'DAIL (DLP) must reimburse the LNA for the cost of the testing', the split between facility-paid and State-paid training depending on employment at the start of the course, the 12-month hiring window and the 1/12th-per-month pro rata reimbursement paid quarterly starting after 90 days of employment, the three documents required to claim it, and the limit that 'Neither the State nor the nursing facility is responsible for reimbursing an individual for licensure expenses.'\", \"url\": \"https://dlp.vermont.gov/sites/dlp/files/documents/NATCEP_Reimbursement.pdf\"}, {\"label\": \"Excel Testing, LLC — Vermont nurse aide testing, the provider that DAIL's Division of Licensing and Protection links as 'Vermont Nurse Aide Testing' and that the Secretary of State lists as the LNA and MNA Examination Information. Establishes 'Excel Testing is an approved testing provider for Vermont', that results go to candidates, program coordinators, DLP and OPR, the two-part written-and-skills structure, the combined '$200' exam fee, the requirement to upload the OPR Authorization to Test letter to the testing portal before results can be released, that 'your seat is NOT reserved until your payment is received', and that the same competency exam serves license reinstatement.\", \"url\": \"https://exceltestingvt.com/\"}, {\"label\": \"Vermont Secretary of State, Office of Professional Regulation — Frequently Asked Questions, Nursing. Establishes the late-renewal consequences under 3 V.S.A. 127(d)(1), the three courtesy renewal notifications and that 'It is solely the licensee's responsibility to know the date their license expires', the attest-then-audit approach to practice hours ('you will not be asked to upload a verification letter at the time of renewal. However, you may be selected in an audit'), the audit itself ('30 days after the renewal period ends, OPR conducts an audit. A percentage of licensees are chosen at random'), and the 12-month carry-over rule for a criminal background check when changing nurse license type.\", \"url\": \"https://sos.vermont.gov/nursing/nursing-faqs\"}, {\"label\": \"Vermont Secretary of State, Office of Professional Regulation — Find a Professional. Establishes the public lookup's purpose and its published result fields (name; city, state, zip; license number and type; issue, effective and expiration dates; license status; and where applicable supervision, endorsements/specialties and disciplinary action), the Profession Roster Download option, and the pointer that a full disciplinary search runs elsewhere — 'A comprehensive search of discipline is available on the Conduct Decision Search page.' Note what this page is not: it describes the lookup and links to it, but carries no licensee-search form itself; the search runs in a separate application on secure.professionals.vermont.gov.\", \"url\": \"https://sos.vermont.gov/opr/find-a-professional/\"}, {\"label\": \"Vermont State Board of Nursing — LNA Scope of Practice Position Statement with Decision Tree (revised July 9, 2018, PDF). Establishes the Board's framing of LNA accountability ('Every LNA is accountable for practicing within the LNA scope of practice'), the nine curriculum subject areas, the delegation pathway for additional tasks, the exclusions (nursing assessments, nursing judgments, development of the plan of care), and the basic skills list.\", \"url\": \"https://outside.vermont.gov/dept/sos/office_professional_regulation/professions/nursing/nursing_board_position_statement_lna_scope_practice.pdf\"}, {\"label\": \"Vermont DAIL, Division of Licensing and Protection — Vermont Adult Abuse Registry. Establishes that Vermont's abuse registry is a subscription-based background-check service for organisations rather than a public lookup: 'Organizations can use this system to submit background registry checks against Vermont's Adult Abuse and Child Protection Registries', in-state organisations may subscribe, and 'Organizations located Out-of-State are not eligible to have a subscription ... and must submit paper checks for both registries.'\", \"url\": \"https://dlp.vermont.gov/aps/adult-abuse-registry\"}, {\"label\": \"Vermont Secretary of State — Nursing Statutes, Rules & Resources. The Board's own index of controlling authority, and the page that links 26 V.S.A. chapter 28 as the Nursing Statutes, the Administrative Rules PDF, the LNA Scope of Practice position statement, and the mandatory reporting statute at 3 V.S.A. 128.\", \"url\": \"https://sos.vermont.gov/nursing/statutes-rules-resources/\"}, {\"label\": \"Excel Testing Service — Vermont LNA registration page (the testing provider both the Division of Licensing and Protection and the Secretary of State link by name). Establishes the combined examination fee and the registration mechanics quoted in exam: 'You will be registering for 2 tests: Written Test and Skills Test for combined exam fees of $200' and 'your seat is NOT reserved until your payment is received'. (The sentence 'The Competency Exam includes two parts: a written test and a skills test' appears on the provider's reinstatement page, exceltestingvt.com/reinstatement/, not on this registration page.)\", \"url\": \"https://exceltestingvt.com/register/\"}, {\"label\": \"Excel Testing Service — Vermont LNA reinstatement page. Establishes the route back for a lapsed license: it is 'for those who currently hold an inactive or expired Vermont LNA License', and 'Individuals looking to reinstate their license MUST have received an Authorization to Test letter from the Vermont Office of Professional Regulation.' It also reproduces Board Rule 4-8(b) verbatim — the strictest of Vermont's three statements of the lapse rule — which is why a reinstating candidate meets that version first.\", \"url\": \"https://exceltestingvt.com/reinstatement/\"}, {\"label\": \"Vermont Office of Professional Regulation — Conduct Decision Search. The page the Find a Professional lookup points to for a complete disciplinary search: 'A comprehensive search of discipline is available on the Conduct Decision Search page.' Cited because the licensee lookup surfaces disciplinary action only 'Where applicable'.\", \"url\": \"https://sos.vermont.gov/opr/complaints-conduct-discipline/conduct-decision-search/\"}]",
   "page_url": "https://licensingatlas.com/cna/vt-cna/"
  },
  {
   "page_id": "wa-cna",
   "state": "Washington",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Washington State Board of Nursing (WABON) — the regulator of nursing assistants since July 1, 2026. Applications, renewals and complaints are still filed through the Washington State Department of Health's HELMS online system, and credentials are still verified through the Department of Health's Provider Credential Search.",
   "board_url": "https://nursing.wa.gov/licensing/licensure-requirements/na-license",
   "application_url": "https://nursing.wa.gov/licensing/licensure-requirements/na-license",
   "renewal_cycle": "Every year, on your birthday. WAC 246-841A-990(1): 'Credentials must be renewed every year on the practitioner's birthday as provided in WAC 246-12-020 through 246-12-051.' WABON says the same for each credential: 'All Nursing Assistant Certified (NACs) in Washington state must renew annually by their birthday to remain in active status,' and the same sentence for NARs. Renewal is filed in the HELMS Online Portal with the fee. The only condition is the fee — there is no work-hours requirement and no continuing education; see the continuing-education details on this page. Two practical points WABON states: an NAC holder does not need to keep the NAR alive ('If you hold an active Nursing Assistant Certification (NAC), you do not need to renew your Nursing Assistant Registration (NAR) credential'), and reactivation does not buy a fresh year — 'Your reactivation fee will pay for your expired license to be brought to the current date it is reactivated. You will still be responsible for paying for your next renewal cycle, even if it is due immediately after your license is reactivated. There is no grace period.' WABON illustrates the trap with its own example: reactivate on December 15 with a December 30 birthday and you renew again on December 30. Its own advice is to wait — 'If you do not need your license reactivated immediately, you may delay submission of your reactivation application until after your birthday.'",
   "ce_hours": "None for either credential, and WABON states it affirmatively rather than leaving it to silence: 'There are no continuing education requirements for NACs' and 'There are no continuing education requirements for NARs.' That is a deliberate contrast on the same page, where WABON writes that it 'requires nursing continuing education and active nursing practice hour requirements for active and retired-active nursing credentials' and imposes, for example, 30 contact hours per two-year cycle on ARNPs. The nursing assistant lines carry neither a continuing education nor an active-practice-hours condition. Sources checked: chapter 246-841A WAC in full (including the fees and renewal rule at 246-841A-990 and the expired-credential rule at 246-841A-980), chapter 18.88A RCW in full (including RCW 18.88A.130 on renewal, which delegates renewal 'according to administrative procedures, administrative requirements, and fees determined by the secretary'), the WABON NA License page, and the WABON Renew or Reactivate a License page including its NAC and NAR sections. One adjacent requirement that is not NAC continuing education: a medication assistant whose endorsement lapses must show 'eight hours of continuing education specific to medications, medication administration, and performance of selected patient treatments' along with 250 hours of medication-assistant employment — a reinstatement condition on a different credential, not a renewal condition on the NAC.",
   "exam": "Two parts, different delivery, different prices, and you take them in order. WABON: 'The Nursing Assistant Certification (NAC) exam consists of two parts: Part 1: In-person Skills Test. Part 2: Online Knowledge Test.' The knowledge test is registered for after the skills test is passed. The rule states the same two-part structure and the pass rule: 'The competency evaluation includes a knowledge exam and a skills competency exam. Students must pass both exams before their nursing assistant-certified application can be approved' (WAC 246-841A-460(1)). For a board-approved-program student 'the skills competency exam takes place after the successful completion of theory, skills lab, and clinical components of the course. The student receives a certificate of completion after successfully completing the state skills competency exam.' For non-routine candidates — 'military training, nursing school students, OBRA reactivation, or as out-of-state applicants who have not tested in another state' — 'the board will work individually with the student to arrange a state competency exam date and time.' Cost: 'Skills Test: (cost is determined by NA program). Online Knowledge Test: $55.' Nine eligibility routes, and knowing yours determines whether you need an Authorization to Test first: E1 new nursing assistant from an approved Washington traditional program; E2 nursing student or nursing program graduate; E3 military nursing student; E4 out-of-state training or nursing program graduate; E5 lapsed credential over 3 years who completed training again; E6 graduate of an approved Washington alternative bridge program; E7 training that occurred before February 1, 2015; E8 OBRA re-activation; E9 training program now closed. Routes E2 through E5 and E7 through E9 must 'Submit a Complete Application with DOH — Credentialing to receive an Authorization to Test prior to registering for the exam.' One route has a harsher rule than the rest: E8, OBRA re-activation, allows 'only 1 re-test attempt allowed; you must pass both parts of the exam on 1st attempt or re-training is required.' Attempts generally: RCW 18.88A.090(2) — 'Any applicant failing to make the required grade in the first competency evaluation may take up to three subsequent competency evaluations as the applicant desires upon prepaying a fee determined by the secretary... for each subsequent competency evaluation. Upon failing four competency evaluations, the secretary may invalidate the original application and require such remedial education before the person may take future competency evaluations.' Program accountability: the board monitors pass rates and 'The program standard for pass rates is: (a) At least 80 percent of first-time test-takers pass the knowledge portion of the examination; and (b) At least 80 percent of first-time test-takers pass the skills portion.' Washington publishes no question count, time limit or passing score for either part, and this page states none.",
   "fees": "WABON publishes a fee table and the rule publishes the same numbers — they reconcile exactly, which is worth saying because most states' code and agency figures do not. Nursing assistant-certified (NAC) and nursing assistant-registered (NAR) carry identical fees: Initial Application $85; Renewal $95; Late Renewal (less than one year late) total $145; Reactivation (more than one year late) total $197. Medication assistant endorsement: $25 initial, $10 renewal. Other charges: Verification of License $25 for all license types; Paper Duplicate License $10 for NAR and NAC — and WABON notes that duplicates are rare, since 'The Washington State Board of Nursing (WABON) is no longer printing credential certificates upon issuance of a nursing credential.' The rule behind those totals itemises them: WAC 246-841A-990 sets, for registration credentials, Application $85.00, Renewal of registration $95.00, Duplicate registration $10.00, Registration late penalty $50.00 and Expired registration reissuance $52.00; and the identical list for certification credentials — Application for certification $85.00, Certification renewal $95.00, Duplicate certification $10.00, Certification late penalty $50.00, Expired certification reissuance $52.00; plus Application for endorsement $25.00 and Endorsement renewal $10.00 for the medication assistant endorsement. So the $145 late-renewal total is the $95 renewal plus the $50 late penalty, and the $197 reactivation total is $95 plus $50 plus the $52 reissuance. Non-refundable, and said twice: the rule calls every fee 'nonrefundable', WABON's fee page says 'All nurse license fees are non-refundable,' its renewal page says 'All renewal and reactivation fees are non-refundable,' and its application page opens with 'Important: There are no refunds.' Exam costs are separate and only half of them is a fixed figure: 'Skills Test: (cost is determined by NA program). Online Knowledge Test: $55.' Not a state fee: training program tuition. Note also that the RN and LPN fees on the same WABON table include HEALWA and Washington Center for Nursing surcharges; no such surcharge appears on the NAR or NAC lines.",
   "legal_basis": "[{\"citation\": \"RCW ch. 18.88A (Nursing Assistants), as amended by 2025 c 5 (SB 5051) and 2025 c 58\", \"what_it_governs\": \"The whole nursing assistant scheme: the legislative declaration and definitions including the two levels of nursing assistant (18.88A.020); board powers (18.88A.060); registration requirements and the three-day filing rule (18.88A.080); the medication assistant endorsement (18.88A.082); certification requirements (18.88A.085); alternative training and internal credentialing reciprocity (18.88A.087); military training (18.88A.088); competency evaluations and the four-failure rule (18.88A.090); certification by endorsement for applicants credentialed in another state (18.88A.110); renewal (18.88A.130); exemptions (18.88A.140); application of the uniform disciplinary act with the board as disciplinary authority (18.88A.150); and nurse delegation (18.88A.200 through.230).\", \"url\": \"https://app.leg.wa.gov/RCW/default.aspx?cite=18.88A&full=true\"}, {\"citation\": \"WAC ch. 246-841A (Nursing Assistants) — rules amended by WSR 26-13-119, filed 6/17/26, effective 7/1/26\", \"what_it_governs\": \"Definitions (246-841A-390); standards of practice (246-841A-400); care settings and student registration timelines (246-841A-403); registered nurse delegation (246-841A-405); training program types, approval, directors and instructors (246-841A-409 through 246-841A-430); the common curriculum and the 108-hour requirement including the nursing assistant-registered work pathway (246-841A-440); competency evaluation and the 80 percent program pass-rate standard (246-841A-460); NAC application requirements (246-841A-463); the alternative bridge programs and their 36-hour requirements (246-841A-530 through 246-841A-585); the medication assistant endorsement and its 100-hour program (246-841A-586 through 246-841A-595); conduct violations, mandatory reporting and discipline (246-841A-600 through 246-841A-740); the expired-credential rule and its three-year line (246-841A-980); and the fee schedule and annual birthday renewal cycle (246-841A-990).\", \"url\": \"https://app.leg.wa.gov/WAC/default.aspx?cite=246-841A&full=true\"}, {\"citation\": \"Laws of 2025, ch. 5 (Senate Bill 5051)\", \"what_it_governs\": \"The transfer of nursing assistant credentialing and discipline from the Secretary of Health to the Washington State Board of Nursing effective July 1, 2026, and the addition of two nursing assistant-certified members to the board plus the broadening of one seat to include an LPN or RN with nursing assistant educator experience. Cited as WABON describes it and as it appears in the statutory history notes and the WSR 26-13-119 rule authority lines; the session law text itself was not separately read.\", \"url\": \"https://nursing.wa.gov/news/2026/washington-state-board-nursing-assume-regulatory-authority-nursing-assistants-beginning-july-1-2026\"}, {\"citation\": \"WAC 246-12-340 and WAC 246-12-020 through 246-12-051 (Department of Health administrative procedures)\", \"what_it_governs\": \"The general credentialing procedures the nursing assistant rules incorporate by reference: WABON's own application page tells applicants 'Before you apply for your credential, please see WAC 246-12-340 about fees,' and the expired-credential rule at WAC 246-841A-980 requires a practitioner to 'meet the requirements as provided in WAC 246-12-020 through 246-12-051' whether the credential has been expired three years or less or longer.\", \"url\": \"https://app.leg.wa.gov/WAC/default.aspx?cite=246-12-340\"}, {\"citation\": \"42 U.S.C. § 1395i-3(e) and (f) (federal nurse aide training and competency evaluation requirements)\", \"what_it_governs\": \"The federal standard Washington's definitions are written against: an 'approved training program' means one approved by the board 'to meet the requirements of a state-approved nurse aide training and competency evaluation program consistent with 42 U.S.C. Sec. 1395i-3(e) and (f) of the federal social security act,' and alternative training must meet the same standard (RCW 18.88A.020(1) and (2); RCW 18.88A.087(2)(b)). The four-month clock for a nursing assistant-registered employed in a nursing home comes from the same federal scheme. Cited because Washington cites it; the federal text was not separately read for this page.\", \"url\": \"https://app.leg.wa.gov/RCW/default.aspx?cite=18.88A.020\"}]",
   "exam_vendor": "Credentia, named by the board itself and by name twice on the same page: 'In most cases, your school will confirm that you completed your training, and our testing vendor, Credentia, will send your test results directly to us.' The board's NAC program page routes candidates to the vendor for one of the two exam parts — 'Register for the Online (or Oral) Knowledge Test AFTER You Pass the Skills Test: Register on the Credentia website' — and lists the vendor's self-help guides, practice knowledge test and skills checklist among its own student resources. The split is unusual and worth getting right: Washington does not hand the whole examination to the vendor. Skills testing is delivered either by the candidate's own training program or by the board's regional scheduler — 'Test candidates who graduate from a Washington State Approved Nursing Assistant Training Program where the program provides skills testing: Schedule the skills exam with your training program' versus 'Test candidates who match a non-routine eligibility route, or test candidates who graduate from a Washington State Nursing Assistant Training Program that does not provide skills testing: Register through WABON online scheduling for a regional skills test.' The statute allows exactly this arrangement: 'The board may approve a competency evaluation prepared or administered by a private testing agency or association of licensing agencies for use by an applicant in meeting the credentialing requirements' (RCW 18.88A.090). The vendor is named here because the state names it; the exam-day details on this page are attributed to the vendor's Washington candidate handbook, and every other fact to a state source.",
   "training_hours": "108 hours for the traditional program — one of the highest state minimums, and the split is fixed by rule rather than left to the school. WAC 246-841A-440(4): 'Program hours. The program director will determine the amount of time required in the curriculum to achieve the objectives. The time designated may vary with characteristics of the learners and teaching or learning variables, but the program must provide a minimum of 108 training hours total, with a minimum of 35 hours of classroom theory, a minimum of 33 hours of skills lab, and a minimum of 40 hours of clinical training. Training to orient the student to the health care facility and facility policies and procedures is required, but shall not be included in the minimum clinical training hours required.' Read that last sentence carefully: facility orientation is mandatory and uncounted, so a 108-hour program is 108 hours of instruction plus orientation on top. The same exclusion is repeated for the bridge programs, and a separate rule adds that live orientation to an online program 'may not be included in the minimum required program hours.' The two bridge programs are 36 hours, with different splits. Home care aide-certified alternative program: 'The minimum required training hours are: 36 hours total, with a minimum of 17 hours of classroom theory, a minimum of 13 hours of skills lab, and a minimum of six hours of clinical training' (WAC 246-841A-545). Medical assistant-certified alternative program: 'The minimum required training hours are: 36 hours total, with a minimum of 16 hours of classroom theory, a minimum of 14 hours of skills lab, and a minimum of six hours of clinical training' (WAC 246-841A-550). The statutory floor behind both is 24 hours — RCW 18.88A.087(1)(b) requires an alternative-training applicant to have 'successfully completed at least twenty-four hours of training that the board determines is necessary to provide training equivalent to approved training on topics not addressed in the training specified for certification as a home care aide or medical assistant' — so the board's rules set the bar half again higher than the statute's minimum. A distinctive Washington option — earning clinical hours at work: WAC 246-841A-440(8) lets a program allow students, case by case, 'to complete their clinical training hours by working as a nursing assistant-registered in a care facility under the supervision of a licensed nurse.' The qualifying conditions include that the work 'Be completed following successful completion of required classroom theory and skills lab hours' and be documented on a board form 'along with formal documentation of the number of hours worked.' Under this pathway the program director must require 'verifiable documentation of supervision and competency evaluation by a supervising licensed nurse prior to awarding clinical training credit,' and 'The student must also provide evidence of at least 40 hours of work in the role of a nursing assistant.' For the medication assistant endorsement, which is a different credential: '100 hours total, with a minimum of 50 hours of classroom theory, a minimum of 10 hours of skills lab, and a minimum of 40 hours of clinical practicum.'",
   "lapse_rule": "Three tiers, split at one year and at three years. Under one year late — just renew: 'You can renew late up to 1 year after your expiration date for RNs, LPNs, NARs, and NACs.' The cost is the $95 renewal plus the $50 late penalty, $145 in total. Over one year late — reactivation: 'If your license is expired for more than one year for an RN, LPN, NAR, or NAC... you may submit a reactivation application through the HELMS Portal,' at $197 total ($95 renewal, $50 late penalty, $52 expired reissuance). Over three years — start over, unless you hold an active credential elsewhere: 'If your NAC license has expired for more than 3 years and you do not have an active license in another U.S. state you will be required to complete a new nursing assistant training program and retest prior to your license being reissued.' The rule frames the same three-year line as a competence test rather than a fixed prescription: WAC 246-841A-980 — 'If the certificate has been expired for three years or less, the practitioner must meet the requirements as provided in WAC 246-12-020 through 246-12-051. If the certificate has expired for over three years, the practitioner shall: (1) Demonstrate competence to the standards established by the board; (2) Meet the requirements of WAC 246-12-020 through 246-12-051.' Both are official and they fit together: WABON's page states how the board applies its competence standard in the ordinary case. There is a dedicated exam route back in: eligibility route E5 covers a 'Lapsed nursing assistant credential >3 years, but completed training again,' and route E8 covers 'OBRA Re-activation' with the strictest attempt rule on the list — 'only 1 re-test attempt allowed; you must pass both parts of the exam on 1st attempt or re-training is required.' No grace period on the other side either: reactivation brings the credential to the current date but does not defer the next birthday renewal, and WABON says plainly 'There is no grace period.'",
   "reciprocity": "Certification by endorsement, and it can skip the exam entirely. RCW 18.88A.110: 'An applicant holding a credential in another state may be certified by endorsement to practice in this state without the competency evaluation if the board determines that the other state's credentialing standards are substantially equivalent to the standards in this state.' Note what the statute does not do — it names no list of approved states and sets no minimum time held; the test is the board's substantial-equivalence judgment, applied case by case. What WABON asks for: 'If you hold an active Certified Nursing Assistant credential in another state, you may be eligible to endorse your certification to Washington State. As part of the application process, you will be required to: Provide your nursing assistant caregiver employment history from the state where you are currently certified; Complete the first part of the verification form and send each state where you have held an active nursing assistant certification. Please have the form sent back to NACapplications@doh.wa.gov. Additional information regarding your education may be requested by email if needed.' So the verification travels state-to-state on a Washington form rather than through a national database — Nursys, which Washington uses for RN and LPN verification, does not cover nursing assistants. A separate, internal form of reciprocity exists inside Washington and is easy to confuse with the interstate kind: RCW 18.88A.087 directs the board to run 'a program of credentialing reciprocity... between home care aide and medical assistant certification and nursing assistant certification,' which is what the two 36-hour bridge programs implement. That is a credential-to-credential bridge within Washington, not a state-to-state transfer. Going the other way: WABON's verification page addresses outbound verification only for RNs, LPNs and ARNPs, and notes that 'we will not verify credentials that are pending, closed, or have only been issued a temporary practice permit.' A dedicated Nursing Assistant Credential Verification Form is published on the WABON site for the nursing assistant case. Washington charges $25 for a verification of license, for all license types.",
   "last_verified": "2026-08-14",
   "source_urls": "[{\"label\": \"Washington State Board of Nursing — Nursing Assistant (NA) License. The core page. Establishes the NAR/NAC choice and 'Important: There are no refunds'; 'No prior training required. With this license, you may start working right away' and 'Registered nursing assistants (NARs) employed in a nursing home have four months to complete an approved training program and testing for certification'; the eight NAC pathways with their document lists (traditional, home care aide bridge, medical assistant bridge, endorsement, nursing school student, out-of-state training, military training, out-of-country training); 'our testing vendor, Credentia, will send your test results directly to us'; the endorsement steps including the verification form returned to NACapplications@doh.wa.gov; the HELMS application steps and the pending credential number; and the medication assistant endorsement requirements including 'at least 1,000 hours of work experience in a nursing home as a nursing assistant-certified within the year immediately before the date of application.'\", \"url\": \"https://nursing.wa.gov/licensing/licensure-requirements/na-license\"}, {\"label\": \"Washington State Board of Nursing — NAC Program Information. Establishes the three program types (traditional, home care aide bridge, medical assistant bridge); the two-part exam ('Part 1: In-person Skills Test. Part 2: Online Knowledge Test'); the exam costs ('Skills Test: (cost is determined by NA program). Online Knowledge Test: $55'); the nine eligibility routes E1 to E9 including the E8 OBRA re-activation single-retest rule; the Authorization to Test requirement for non-routine routes; the two skills-testing options (through the training program, or 'Register through WABON online scheduling for a regional skills test'); 'Register on the Credentia website' for the knowledge test; and the governing law references RCW 18.88A and WAC 246-841A.\", \"url\": \"https://nursing.wa.gov/education/nursing-assistant-training/na-program-student-info/nursing-assistant-certification-nac-information\"}, {\"label\": \"Washington State Board of Nursing — Renew or Reactivate a License. Establishes 'All Nursing Assistant Certified (NACs) in Washington state must renew annually by their birthday to remain in active status'; 'There are no continuing education requirements for NACs' and the identical sentence for NARs; 'You can renew late up to 1 year after your expiration date for RNs, LPNs, NARs, and NACs'; the over-one-year reactivation route; 'If your NAC license has expired for more than 3 years and you do not have an active license in another U.S. state you will be required to complete a new nursing assistant training program and retest prior to your license being reissued'; that an active NAC makes NAR renewal unnecessary; and the no-grace-period reactivation rule with WABON's own worked example.\", \"url\": \"https://nursing.wa.gov/licensing/renew-or-reactivate-license\"}, {\"label\": \"Washington State Board of Nursing — Nurse License Fees. Establishes the NAC and NAR fee line ($85 initial application, $95 renewal, $145 late renewal total, $197 reactivation total), the Medication Assistant Endorsement line ($25 / $10), the NTEC line, 'Verification of License $25 for all license types', 'Paper Duplicate License... $10 for NAR & NAC', and 'All nurse license fees are non-refundable.'\", \"url\": \"https://nursing.wa.gov/licensing/nurse-license-fees\"}, {\"label\": \"Washington State Board of Nursing — Verify or Check License Status. Establishes that WABON 'is no longer printing credential certificates upon issuance of a nursing credential' and that the Department of Health's Provider Credential Search 'should be used by all healthcare providers, facilities, employers, and the public to verify Washington state licensure status'; the Active / Pending / Closed status meanings; that Nursys covers RN and LPN licenses and indicates single-state versus multistate while the DOH search does not; and the $25 verification arrangement.\", \"url\": \"https://nursing.wa.gov/licensing/verify-license\"}, {\"label\": \"Washington State Board of Nursing — news release: WABON to assume regulatory authority for nursing assistants beginning July 1, 2026. Establishes the SB 5051 transfer of credentialing and disciplinary authority from the Secretary of Health to the board; the four 'what's changing / what's not changing' briefings for employers, active nursing assistants, training programs and the public; that applications, renewals and complaints stay in the Department of Health's HELMS system and the Provider Credential Search stays the verification tool; that existing credentials remain valid; and the board-composition change adding two nursing assistant-certified members.\", \"url\": \"https://nursing.wa.gov/news/2026/washington-state-board-nursing-assume-regulatory-authority-nursing-assistants-beginning-july-1-2026\"}, {\"label\": \"Washington Administrative Code chapter 246-841A (Nursing Assistants), full chapter text from the Washington State Legislature. Establishes the 108-hour traditional program and its 35/33/40 split with the orientation exclusion (246-841A-440(4)); the nursing assistant-registered clinical work pathway and its 40-hour evidence requirement (246-841A-440(8)); the 36-hour home care aide bridge at 17/13/6 (246-841A-545) and the 36-hour medical assistant bridge at 16/14/6 (246-841A-550); the two-part competency evaluation, the non-routine candidate arrangement and the 80 percent pass-rate standard (246-841A-460); the NAC application requirements (246-841A-463); the care settings and three-day student registration rule (246-841A-403); the 100-hour medication assistant endorsement program (246-841A-590) and its 1,000-hour experience and 250-hour/8-CE reinstatement conditions (246-841A-595); the expired-credential three-year rule (246-841A-980); and the complete fee schedule with the annual birthday renewal cycle (246-841A-990).\", \"url\": \"https://app.leg.wa.gov/WAC/default.aspx?cite=246-841A&full=true\"}, {\"label\": \"Revised Code of Washington chapter 18.88A (Nursing Assistants), full chapter text from the Washington State Legislature. Establishes the definitions and the two levels (18.88A.020); the registration issuance rule and 'Applicants must file an application with the board for registration within three days of employment' (18.88A.080); the certification requirements (18.88A.085); the alternative training and credentialing-reciprocity mandate with its 24-hour floor (18.88A.087); the competency evaluation provisions including the four-failure rule and the authority to approve a private testing agency's examination (18.88A.090); certification by endorsement on substantial equivalence (18.88A.110); renewal by the secretary's administrative requirements (18.88A.130); the exemptions (18.88A.140); the board as disciplinary authority under the uniform disciplinary act (18.88A.150); and the nurse-delegation training requirements including specialized diabetes training (18.88A.210).\", \"url\": \"https://app.leg.wa.gov/RCW/default.aspx?cite=18.88A&full=true\"}, {\"label\": \"Washington State Department of Health — Provider Credential Search (the public verification tool WABON directs everyone to; it redirects to the department's HELMS license-search application). Its own search form establishes the search options listed under Verify a license on this page: first name, last name, credential status, credential type, credential number, business address, city and ZIP code.\", \"url\": \"https://fortress.wa.gov/doh/providercredentialsearch/\"}]",
   "page_url": "https://licensingatlas.com/cna/wa-cna/"
  },
  {
   "page_id": "wi-cna",
   "state": "Wisconsin",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Wisconsin Department of Health Services (DHS), Division of Quality Assurance — Nurse Aide Training and Testing, which maintains the Wisconsin Nurse Aide Registry. No board of nursing is involved. Day-to-day testing and registry operations run on a state contractor's system: DHS states that 'Wisconsin TestMaster Universe (TMU) houses the Wisconsin Nurse Aide Testing and Registry system. Headmaster hosts our registry.'",
   "board_url": "https://www.dhs.wisconsin.gov/caregiver/nurse-aide/index.htm",
   "application_url": "https://www.dhs.wisconsin.gov/caregiver/nurse-aide/nurse-aide.htm",
   "renewal_cycle": "Every 24 months, and what renews it is work, not a fee or a course. DHS: 'The date you pass the competency test begins your 24-month work eligibility period. A new eligibility period begins every 24 months. To remain eligible for work as a nurse aide, federal regulations require that you: Work at least eight hours in a 24-month period. Provide hands-on care in a paid position. Be under the supervision of an RN or LPN.' The work has to happen in one of seven listed settings — a federally certified nursing home, a hospice, a home health agency, an intermediate care facility for individuals with intellectual disabilities, a state-licensed hospital, a facility for people with developmental disabilities, or a rural medical center providing one or more of those services. Self-employment does not count: the candidate handbook states that 'self-employment and private-duty experience are not recognized as work experience that qualifies for federal eligibility.' How it is filed: the aide, not the employer, starts it. 'If your certification will expire in the next 90 days, you'll have the option to add your employer on TMU' — select the Employment tab, Add Employment, choose Nurse Aide under Certification, choose the employer, enter the dates, and submit the request; 'The employer will log in to their TMU account to approve or deny the request. For more information, see Providers Verifying CNA Employment. After your employer approves your request, we will extend your federal eligibility for 24 months.' DHS notes the change from the old practice: 'In the past, employers submitted renewal forms in a mass mailing with other nurse aides. However, you now submit renewals for yourself.' Reminders come from the contractor, not the state, and only to the contact details you keep current: 'About 60 days before your eligibility period ends, Headmaster will send you a reminder to renew... to your email address on record and/or a text to your cell phone. Your phone must be able to receive SMS.' If your employer is not in the system there is a paper route: 'Complete a Wisconsin Nurse Aide Registry Renewal Form, F-03211 (PDF) and give to your employer to complete Section 2', returned by fax or email to the department. There is no fee at any point in this cycle and no continuing education — see the continuing-education details on this page.",
   "ce_hours": "None. Wisconsin requires no continuing education to keep a nurse aide listed on its registry. The only recurring condition is the paid-work requirement described under renewal — at least eight hours of hands-on nurse aide work for pay under RN or LPN supervision in each 24-month period. Sources checked and found silent on continuing education for nurse aides: Wis. Stat. § 146.40 in full, Wis. Admin. Code ch. DHS 129 (the chapter table of contents, plus the definitions at 129.03, the training-program standards at 129.07, the competency evaluation standards at 129.08 and the registry rule at 129.09), the DHS Nurse Aide Training and Registry home page, the Becoming a CNA page, the Maintaining Registry Status page, the registry FAQ page, the Providers Verifying Nurse Aide Employment page, and the Wisconsin Nurse Aide Candidate Handbook. Nothing in any of them conditions continued listing on hours of instruction. In-service training is a different thing and belongs to the employer: federal nursing home requirements oblige facilities to provide in-service education to their nurse aides, but that is an obligation on the facility under its own conditions of participation, not a condition Wisconsin attaches to registry status, and no Wisconsin source read states an in-service hour figure as a registry requirement. The one continuing-education-shaped obligation in this area belongs to a different credential: the medication aide, whose eligibility conditions include a Wisconsin-approved medication aide course and an examination with an 85% pass mark.",
   "exam": "Two parts — a knowledge test and a skills demonstration — and you must pass both. Wis. Admin. Code § DHS 129.03(9) defines the competency evaluation program as consisting of 'A written or oral examination' and 'A skills demonstration examination', and DHS tells candidates to 'Pass the competency exam, which includes a written knowledge test and a skill test.' Knowledge test, as the state-linked candidate handbook describes it: 'The Knowledge Exam consists of 75 multiple-choice questions. Questions are selected from subject areas in accordance with the approved DHS test plan and include all required categories defined in Federal regulations.' You get 'sixty (60) minutes to complete the 75-question exam', answers are A through D, you may navigate with previous and next buttons, and you are warned at the 45-minute mark that 15 minutes remain. 'To pass the knowledge portion of the exam, you must score 71% or better.' An audio version is offered, in which 'The knowledge test questions and answers are read through the computer and listened to through headphones or earbuds while you read along.' Testing is electronic, and results move fast: passing candidates reach the registry 'no later than the next business day.' Skills test: the handbook says each candidate performs one mandatory task plus 'an additional two (2) or three (3) randomly selected tasks', with 'no more than thirty (30) minutes to complete your three (3) or four (4) tasks' and a warning when 15 minutes remain. The four possible mandatory openers are assisting a resident with a bedpan (modified), catheter care for a female resident, donning an isolation gown and gloves with emptying a urinary bag and measuring output, and perineal care for a female resident; the catheter and perineal tasks are demonstrated on a manikin and the rest on a live resident actor, and 'Handwashing is embedded in each mandatory task and must be demonstrated at the end of each.' Scoring: 'You must correctly perform all key steps (in bold font) and 80% of all non-key steps in each task assigned to pass the Skill Test', and 'All steps must actually be demonstrated. Steps that are only verbalized WILL NOT COUNT.' A candidate may say they made a mistake and redo the step. ⚠ Two official sources give different numbers for the skills test, and this page does not pick one. The administrative rule says 'The skills demonstration shall consist of a demonstration of at least 5 randomly selected items drawn from a pool consisting of the tasks generally performed by nurse aides' (Wis. Admin. Code § DHS 129.08(3)(b)), while the current Wisconsin Nurse Aide Candidate Handbook — the version dated June 2026 that DHS links from its own page — describes three or four tasks. Both are quoted here with their sources; we found no reconciliation published by the department. The written exam has a similar floor-versus-practice gap that is not a conflict: the rule requires 'A minimum of 50 written or oral questions' with stated minimums per care area (at least 4 on interpersonal communication, 7 on basic nursing skills, 1 on personal care skills, 3 on basic restorative services, 5 on client rights and 5 on dementias), and the examination actually given runs 75 questions — above the floor, which is what a floor allows. Oral testing is available by rule for candidates with limited literacy skills, adapted from the written examination and including 'a component to determine the aide's ability to read basic, objective, job-related information, such as reading a client's name band or a client's flow sheet' (DHS 129.08(2)(e)); the rule also bars a program from refusing to test in a language that is predominant in the candidate's work setting (DHS 129.08(2)(d)). Retakes are unlimited, and only the failed half is retaken — see the lapse and reinstatement details on this page and the note on this page on Wis. Admin. Code § DHS 129.08(4).",
   "fees": "Wisconsin charges nothing for the registry itself — no application fee, no listing fee, no renewal fee. No fee for placement on or renewal of the Wisconsin Nurse Aide Registry appears in Wis. Stat. § 146.40, in Wis. Admin. Code ch. DHS 129, on any of the DHS nurse aide pages, or in the candidate handbook, all checked. That is not a Wisconsin quirk but a federal prohibition: 'The State may not impose any charges related to registration on individuals listed in the registry' (42 CFR 483.156(b)(4)). What does cost money is the examination, paid to the testing contractor. The candidate handbook's fee table, which carries the note 'EFFECTIVE JUNE 7, 2026: The testing fees have been increased', reads: Knowledge Exam and Demonstration/Skills $144.70; Audio Version of the Knowledge Exam and Demonstration/Skills $150.15; Knowledge Exam Only $37.49; Audio Version of the Knowledge Exam Only $42.94 (itemised on the same page as '$37.49 Knowledge Exam Fee + 5.45 for an Audio Version'); Demonstration/Skills Only $107.21. Payment is by Visa or MasterCard credit or debit card online, or by money order, cashier's cheque or facility cheque made payable to D&SDT on a paper payment form; 'Personal checks and cash ARE NOT accepted from candidates.' Rescheduling is free up to one business day before the test; a no-show forfeits the fee. Many candidates pay nothing at all, and the rule that makes that so is federal: DHS states that 'In accordance with 42 CFR 483.152(c) a nurse aide who is employed by a skilled nursing facility, or who has an offer of employment from a skilled nursing facility on the date they begin a nurse aide training program, cannot be charged for any portion of the program (including testing).' There is also a look-back: 'If a nurse aide becomes employed by a skilled nursing facility within 12 months after completing a nurse aide training and competency evaluation program, they are eligible to be reimbursed by the facility for their training and testing cost at a rate that is determined by Wisconsin Medicaid.' DHS additionally points to WisCaregiver Careers ('a free training program to become a nurse aide through employment with participating skilled nursing facilities'), FoodShare Employment and Training, and Job Center of Wisconsin WIOA and TAA funds. Not a state fee: tuition charged by a private training program, which Wisconsin does not set.",
   "legal_basis": "[{\"citation\": \"Wis. Stat. § 146.40 (Instructional programs for nurse aides; reporting client abuse)\", \"what_it_governs\": \"The whole Wisconsin nurse aide scheme at statute level: the definition of nurse aide; the employment bar in sub. (2) and its alternatives, including the fewer-than-120-day trainee window in sub. (2)(c) and the military-experience route in sub. (2)(am); the out-of-state 2,088-hour routes and waiver in sub. (2g); the department's duty to approve instructional programs in sub. (3) and the bar on requiring more than the federal minimum hours; competency evaluation program approval; the registry; and findings of client abuse, neglect and misappropriation.\", \"url\": \"https://docs.legis.wisconsin.gov/statutes/statutes/146/40\"}, {\"citation\": \"Wis. Admin. Code ch. DHS 129 (Certification of programs for training and testing nurse aides, medication aides and feeding assistants)\", \"what_it_governs\": \"The rule chapter. Subchapter I carries the definitions at DHS 129.03, including 'nurse aide', 'competency evaluation program', 'direct supervision', 'general supervision' and 'feeding assistant', plus waivers and variances at 129.04. Subchapter II covers nurse aide training and testing: program approval (129.05), instructor standards including the RN primary instructor and the 16-hour train-the-trainer course (129.06), the six-area curriculum and the clinical conditions (129.07), competency evaluation standards including the question minimums, the skills demonstration and the unlimited-retake rule (129.08), the registry and its contents (129.09), and appeals (129.10). Subchapters III and IV cover feeding assistants and medication aides, which this page does not document.\", \"url\": \"https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/129\"}, {\"citation\": \"Wis. Admin. Code § DHS 129.08 (Standards for nurse aide competency evaluation programs), sub. (4) as amended by CR 25-055, Register February 2026 No. 842, effective 3-1-26\", \"what_it_governs\": \"The examiner qualification (an RN with at least one year caring for the elderly or chronically ill), the written or oral component including the 50-question minimum and the per-area question minimums, oral testing for candidates with limited literacy, the non-English testing rule, the skills demonstration drawn at random from a pool, and the retake rule: only the failed component is retaken, as many times as needed, with different content each time.\", \"url\": \"https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/129/ii/08\"}, {\"citation\": \"Wis. Admin. Code § DHS 129.09 (Registry)\", \"what_it_governs\": \"What the registry holds on each person, including employment eligibility, training and competency evaluation dates, the date of inclusion, out-of-state findings and any Wisconsin finding of abuse, neglect or misappropriation with the aide's rebuttal statement; the 30-day deadline for adding a person who has passed the competency evaluation; applications for inclusion by an individual or an employer; and the public-information rule that exempts only the social security number.\", \"url\": \"https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/129/ii/08\"}, {\"citation\": \"42 CFR 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal floor Wisconsin's statute expressly points to: no less than 75 clock hours of training, at least 16 hours of supervised practical training, at least 16 hours of specified classroom subjects before any direct resident contact, the curriculum areas, instructor qualifications, and the prohibition in 483.152(c) on charging a nurse aide who is employed by — or has an offer of employment from — a skilled nursing facility for any part of the program, including testing.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}, {\"citation\": \"42 CFR 483.154 and 42 CFR 483.156 (competency evaluation; nurse aide registry)\", \"what_it_governs\": \"The attempt floor — a State 'may impose a maximum upon the number of times an individual may attempt to complete the competency evaluation successfully, but the maximum may be no less than three' (483.154(f)(2)) — the 30-day deadline for recording a pass, the State's duty to determine who no longer qualifies to remain on the registry after 24 consecutive months without nursing or nursing-related services, and the bar on charging individuals for registration (483.156(b)(4)).\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D\"}]",
   "exam_vendor": "D&S Diversified Technologies LLP (D&SDT) — Headmaster LLP, operating the Wisconsin TestMaster Universe (TMU) system at wi.tmutest.com. DHS names the contractor itself, in its own words: 'Wisconsin TestMaster Universe houses our Nurse Aide Testing and Registry system. Headmaster hosts the registry', and it publishes the contractor's two contact lines — registry questions to 888-401-0465, testing questions to 888-401-0462, both at wisconsin@hdmaster.com. The candidate handbook, which DHS links from its own 'Becoming a CNA' page, states the approval directly: 'Wisconsin has approved D&S Diversified Technologies LLP (D&SDT)-HEADMASTER LLP' to deliver the competency examination. The contractor does more than test here than in most states: it also hosts the registry itself, sends the renewal reminders, receives the out-of-state and waiver applications, and processes demographic changes. The vendor is named because Wisconsin names it; no vendor page is cited for any legal requirement on this page, and the state's own rule at Wis. Admin. Code § DHS 129.08 sets the standards the examination has to meet.",
   "training_hours": "75 hours total, including 16 hours of clinical — and Wisconsin is unusual in that its legislature has forbidden the department to require more. Wis. Stat. § 146.40(3): 'the department shall approve instructional programs for nurse aides that apply for, and satisfy standards for, approval that are promulgated by rule by the department. The department may not require an instructional program to exceed the federally required minimum total training hours or minimum hours of supervised practical training under 42 CFR 483.152 (a).' The federal figures that sentence points to are, in the regulation's own words, that a program must 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training. Supervised practical training means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse' (42 CFR 483.152(a)(1) and (a)(3)). So the state minimum and the federal floor are the same number by statutory design, and a Wisconsin program that runs longer does so by its own choice, not by state mandate. DHS applies the same two figures to incoming applicants, which is the clearest confirmation that they are the operative Wisconsin numbers: 'You must have completed a minimum 75-hour state-approved nurse aide training program to be considered for the Wisconsin Nurse Aide Registry', and, for a candidate who is inactive elsewhere, 'To apply to test, you must have completed a state-approved training program of 75 hours, including 16 hours of clinical work.' DHS treats 16 clinical hours as tight rather than generous, telling programme applicants in its own aside: 'With only 16 hours of clinical required, students cannot afford to miss any opportunities!' A separate 16 hours sits at the front of the course: at least 16 hours of classroom instruction in communication and interpersonal skills, infection control, safety and emergency procedures, promoting residents' independence, and respecting residents' rights must come before any direct contact with a resident or client. Wisconsin does not publish a required classroom/lab split beyond that, and this page states none. Wis. Admin. Code § DHS 129.07 prescribes the content of the curriculum in detail and sets no total-hours or classroom/lab-split figure of its own. It does set one hour limit, and it is unusual enough to be worth knowing: § DHS 129.07(2)(c)1.k. provides that 'The length of the clinical day may not exceed 8 hours.' That is a cap on a single day of clinical instruction, not on the programme's totals.",
   "lapse_rule": "Losing federal eligibility means re-testing — but not re-training, and Wisconsin states that in one sentence: 'If you haven't met the minimum work requirements within the past 24 months, you need to test again. This includes both a skills test and a written test. Wisconsin doesn't require retraining if you lose federal eligibility.' The candidate handbook says the same from the other side: 'you must successfully pass both components of the approved Wisconsin nurse aide competency examination. Contact D&SDT-HEADMASTER for authorization to schedule the competency test to regain federal employment eligibility status.' You are not removed from the registry in the meantime. DHS answers 'Can I still work if my federal certification lapses?' with 'Yes, but not in a federally certified facility... If you don't maintain your federal eligibility, you can retain your status as a nurse aide. This allows you to work in: Hospitals, including critical access hospitals. Facilities that aren't certified as Medicaid providers.' The federal rule behind the 24-month line is 42 CFR 483.156(b)(3), which directs the State to determine which individuals 'do not qualify to remain on the registry because they have performed no nursing or nursing-related services for a period of 24 consecutive months.' Late is not the same as lapsed: if you have in fact worked, you can still file after the date has passed — 'My work eligibility expired. Can I still work as a nurse aide? Yes. If you've worked as a nurse aide for 24 months or more, log in to your TMU account. List your work experience from the previous 24 months.' And a pending verification does not stop you working: 'A federally certified health care facility may continue to employ you as a nurse aide. This applies if they have verified you worked at least eight hours in the past 24 months.' Retakes are unlimited and partial. Wis. Admin. Code § DHS 129.08(4): 'If a person fails to pass any component of the competency evaluation examination, the individual need only retake the failed component. The person may retake the component failed as many times as needed. The competency evaluation program shall ensure that each repeat examination shall differ in content from any examination previously taken by the individual.' That subsection was amended by CR 25-055, Register February 2026 No. 842, effective 3-1-26, so the unlimited-retake wording is recent. Federal law would have allowed Wisconsin to cap attempts — 'The State may impose a maximum upon the number of times an individual may attempt to complete the competency evaluation successfully, but the maximum may be no less than three' (42 CFR 483.154(f)(2)) — and Wisconsin has not. Two other time limits bite earlier: a newly trained candidate must pass both parts within one year of completing training, after which 'you must complete another DHS-approved training program'; and a candidate removed from a test event for cheating or misconduct 'may not be allowed to retest for at least 6 months and may require DHS permission to retake the test.' A misconduct finding is not a lapse but a bar, and it is permanent on the federal side for nursing homes.",
   "reciprocity": "Wisconsin calls it reciprocity, runs it through the testing contractor, and splits it by whether your home-state status is active. Since 2020 the department has been out of the paperwork: 'We stopped manually processing reciprocity/endorsement forms on June 1, 2020. Headmaster serves as the primary source to verify your work eligibility.' Applications are filed on the Out-of-State application form at the contractor's Wisconsin site, and DHS lists the required attachments: 'Proof of Training and/or Employment Verification; Image of your social security card; Image of your valid US government issued photo identification.' Active and in good standing elsewhere: if your training was a 75-hour programme including 16 clinical hours and your competency examination 'is the same or substantially similar to the Wisconsin competency examination', your name is placed on the Wisconsin registry after you complete the transfer in the contractor's system. If your training qualifies but your examination was not substantially similar, 'you will be required to successfully complete the Wisconsin examination within one (1) year of receiving approval to test.' Inactive elsewhere: 'you will need to either renew your state's registry status or complete competency testing in Wisconsin. To apply to test, you must have completed a state-approved training program of 75 hours, including 16 hours of clinical work.' Proof of training is strict: 'The date of completion must be noted. State registry printouts and certificates that do not provide training program names or dates of completion are not acceptable.' Acceptable proof is a diploma or transcript with the completion date, or a letter from the training program stating where and when training was completed. The employment substitute, when you cannot prove the training: 'Your employer must verify you worked as a nurse aide under the direction of a registered nurse (RN) or licensed practical nurse (LPN) for at least 2,088 hours in the two years preceding your application.' That figure is statutory — Wis. Stat. § 146.40(2g) provides two routes for an individual 'previously employed in another state as a nurse aide for 2,088 hours or more within the prior 2-year period', one adding the person to the registry outright where the out-of-state competency evaluation was substantially similar, the other issuing a waiver from the instructional-program requirement so the person can sit the Wisconsin examination. Fail both tests and Wisconsin sends you back to the start: 'You must retrain and test in Wisconsin if you cannot provide documentation that you completed a state-approved minimum 75-hour nurse aide training program or do not have employer verification.' One state is singled out: 'Alabama applicants: If you originally trained in Alabama more than two years ago and are only certified in Alabama, you must also include employment verification that you worked as a nurse aide under the direction of RN/LPN during the previous two years.' A statutory trap for anyone trained in Wisconsin under § 146.40(3g): an individual who completes a programme approved under that subsection and who previously completed a competency evaluation in another state 'must successfully complete a competency evaluation program that is approved under sub. (3m), regardless of whether the competency evaluation program that the individual completed in another state is the same as or substantially similar.' Going the other way: 'To transfer your listing on the Wisconsin Nurse Aide Registry to another state's nurse aide registry' — make sure your Wisconsin federal eligibility is current, 'Contact the new state's registry to learn that state's requirements', and complete that state's application; Wisconsin's contractor record shows your training, testing, initial placement date, federal eligibility expiry and any substantiated findings. Grandparenting does not transfer: 'On January 1, 2000, we stopped placing individuals on the Wisconsin Nurse Aide Registry under the Grandparent program. The program allowed past work experience to replace training and testing.'",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: Training and Registry (the programme's home page). Establishes that 'The Wisconsin Nurse Aide Registry lists the names of CNAs who meet federal and/or state requirements', the four public entry points (becoming a CNA, out-of-state reciprocity, maintaining registry status, provider verification), the statement of governing law (42 CFR Part 483, Wis. Admin. Code ch. DHS 129, Wis. Stat. ch. 146), the contractor split ('Questions about the registry? Call Headmaster toll-free at 888-401-0465... Questions about testing? Call Headmaster toll-free at 888-401-0462'), and the department's own contact at 608-261-9315.\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/index.htm\"}, {\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: Becoming a CNA in Wisconsin. Establishes 'We include every CNA (certified nurse aide) in our state on the Wisconsin Nurse Aide Registry'; the two-part inclusion rule and 'The state of Wisconsin must approve both programs'; the three-step route for new students; the student nurse, graduate nurse, practising RN/LPN and military routes with their document lists and the military first-attempt rule; both out-of-state routes with the 75-hour and 16-clinical-hour proof requirements, the 2,088-hour employment alternative and the Alabama note; the retraining consequence; and the financial-support section quoting 42 CFR 483.152(c) and the 12-month facility reimbursement rule.\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/nurse-aide.htm\"}, {\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: Maintaining Registry Status. Establishes 'When an individual is placed on the Wisconsin Nurse Aide Registry, they are given two eligibilities: federal and state', that federal eligibility 'lapses every two years in accordance with the federal regulation 42 CFR Part 483' and that the law 'does not permit temporarily extending federal eligibility or waiving of the requirement'; the 90-day window to add an employer in the contractor's system and the step-by-step renewal sequence; and the lapse rule 'you need to test again. This includes both a skills test and a written test. Wisconsin doesn't require retraining if you lose federal eligibility.'\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/maintain-status.htm\"}, {\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: FAQs about the Nurse Aide Registry. Establishes the four-month trainee work window and the 120-day exam deadline; the registry search fields and the six data points a search returns; 'Wisconsin no longer issues nurse aide cards'; the 24-month eligibility period, the eight-hours-of-paid-work rule and the seven qualifying settings; the 60-day contractor reminder; 'Can I still work if my federal certification lapses? Yes, but not in a federally certified facility'; that a pending verification does not stop employment; the outbound transfer steps and the June 1, 2020 end of manual reciprocity processing; and the January 1, 2000 end of the Grandparent program.\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/nar-faq.htm\"}, {\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: Providers Verifying Nurse Aide Employment. Establishes the employer side of renewal: 'each CNA (certified nurse aide) must work for pay at least eight hours during each 24-month certification period. An RN (registered nurse) or LPN (licensed practical nurse) must supervise the work', the same seven qualifying settings, the employment-queue verification steps and the affidavit an employer checks, and the paper Wisconsin Nurse Aide Registry Renewal Form F-03211 route for employers not listed in the contractor's system.\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/providers.htm\"}, {\"label\": \"Wisconsin Department of Health Services — Nurse Aide Program: Starting or Maintaining a Nurse Aide Training Program. Establishes that 'The Division of Quality Assurance (DQA) must approve each CNA (certified nurse aide) training program... before instruction can begin'; the six core curriculum areas; 'The training program must provide classroom instruction of at least 16 hours prior to a trainee's direct contact with a resident or client' with the five listed subjects; the department's own aside 'With only 16 hours of clinical required, students cannot afford to miss any opportunities!'; the primary instructor requirements; the 6-to-8 clinical ratio; the three-year record retention rule; and the list of approved train-the-trainer programmes.\", \"url\": \"https://www.dhs.wisconsin.gov/caregiver/nurse-aide/natd-application.htm\"}, {\"label\": \"Wis. Stat. § 146.40 (Instructional programs for nurse aides; reporting client abuse), Wisconsin Legislature. Establishes the definition of nurse aide at (1)(d); the employment bar at (2) and the fewer-than-120-day trainee window at (2)(c) with its two conditions; the military-equivalence route at (2)(am); the two 2,088-hour out-of-state routes at (2g)(a) and (b); and the sentence that fixes Wisconsin's training length — 'The department may not require an instructional program to exceed the federally required minimum total training hours or minimum hours of supervised practical training under 42 CFR 483.152 (a).'\", \"url\": \"https://docs.legis.wisconsin.gov/statutes/statutes/146/40\"}, {\"label\": \"Wis. Admin. Code ch. DHS 129, subch. II — §§ DHS 129.06, 129.07, 129.08 and 129.09, Wisconsin Legislature. Establishes the RN primary instructor standard and the 16-hour train-the-trainer minimum; the six curriculum care areas and the clinical rules including the 8-hour maximum clinical day, the 6-to-8 student ratio and the 3-year record retention; the competency evaluation standards including 'A minimum of 50 written or oral questions', the per-area question minimums, oral testing for limited literacy, the skills demonstration 'of at least 5 randomly selected items', and the retake rule at 129.08(4) as amended effective 3-1-26; and the registry contents, the 30-day listing deadline and the public-information rule at 129.09.\", \"url\": \"https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/129/ii/08\"}, {\"label\": \"Wis. Admin. Code § DHS 129.03 (Definitions), Wisconsin Legislature. Establishes the definitions this page relies on: 'competency evaluation program' as a written or oral examination plus a skills demonstration examination; 'direct supervision' and 'general supervision'; 'health care provider'; 'feeding assistant' with its 16-year minimum; 'nursing home medication aide' and 'hospice medication aide'; and the six-part inclusive definition of 'nurse aide' at (30)(a) together with the exclusions at (30)(b) and (c), including 'A volunteer is not a nurse aide'.\", \"url\": \"https://docs.legis.wisconsin.gov/code/admin_code/dhs/110/129/i/03\"}, {\"label\": \"Wisconsin Nurse Aide Candidate Handbook, June 2026 (Version 75), D&S Diversified Technologies LLP — Headmaster LLP, the handbook the Department of Health Services links from its own Becoming a CNA page and tells candidates to read. Establishes 'Wisconsin has approved D&S Diversified Technologies LLP (D&SDT)-HEADMASTER LLP' to deliver the examination; the fee table under the heading 'EFFECTIVE JUNE 7, 2026: The testing fees have been increased'; the knowledge exam's 75 multiple-choice questions, 60 minutes and 71% pass mark; the skills exam's mandatory-task list, three-or-four-task structure, 30-minute limit and the rule that all key steps and 80% of non-key steps must be performed; the one-year post-training testing deadline; the reschedule and no-show policies and the six-month bar after removal for misconduct; the out-of-state active and inactive transfer rules; the medication aide eligibility list and its 85% pass mark; and the Caregiver Program description covering background checks, rehabilitation review and work limitations.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/wisconsin/WIformpages/WIforms/WICandidateHandbook.pdf\"}, {\"label\": \"Wisconsin TestMaster Universe — public registry search (the lookup the Department of Health Services directs the public and employers to). Its own search form establishes the four search modes listed under Verify a license on this page: Name, SSN, Registration Number and Misconduct.\", \"url\": \"https://wi.tmutest.com/search\"}, {\"label\": \"42 CFR 483.152, eCFR. Establishes the federal minimums Wis. Stat. § 146.40(3) incorporates by reference: 'Consist of no less than 75 clock hours of training'; 'Include at least 16 hours of supervised practical training'; and 'At least a total of 16 hours of training in the following areas prior to any direct contact with a resident.' Section 483.152(c) is the no-charge rule the Department of Health Services quotes to candidates employed by, or holding an offer from, a skilled nursing facility.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/wi-cna/"
  },
  {
   "page_id": "wv-cna",
   "state": "West Virginia",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "West Virginia Office of Health Facility Licensure and Certification (OHFLAC) — Nurse Aide Program (NAP). OHFLAC is now defined by rule as 'The West Virginia Office of Health Facility Licensure and Certification within the Office of Inspector General' (71 CSR 18-2.13), and the Nurse Aide Program is 'The program within the Office of Health Facility Licensure and Certification (OHFLAC) responsible for oversight of the nurse aide training and competency evaluation programs throughout the state and maintenance of the Nurse Aide registries including the Nurse Aide Abuse and Neglect Registry' (71 CSR 18-2.12). No board of nursing is involved: West Virginia's Board of Examiners for Registered Professional Nurses and its LPN board license nurses, while OHFLAC runs the aide registry, approves the training programs, contracts the testing vendor and decides abuse and neglect findings. Nurse Aide/AMAP Programs office: 1 Players Club Dr., Suite 301, Charleston, WV 25311; (304) 558-0050; ohflacnap@wv.gov.",
   "board_url": "https://ohflac.wvdhhr.org/Programs/NA.html",
   "application_url": "https://ohflac.wvdhhr.org/Programs/NA.html",
   "renewal_cycle": "Every two years, and the test is a very small amount of paid work — eight hours. OHFLAC's policy manual states both: 'Re-registration of the nurse aide status on the registry is required every two (2) years' and 'The minimum amount of paid employment as a nurse aide is eight hours within the previous two year period.' That eight-hour floor is among the lowest in the country; several states require 200 hours or more for the same 24-month cycle. What counts: 'Paid employment as a nurse aide under RN supervision in a direct care setting can be reported to renew the nurse aide's employment status on the Nurse Aide Registry. Only direct care settings that provide RN supervision are acceptable.' The listed settings are clinics; community-based residential facilities; emergency centers (immediate care centers, trauma centers); home health agencies; hospitals; intermediate care facilities for individuals with intellectual disabilities; and nursing homes. 'Other supervised paid nursing-related services may be considered on a case-by-case basis.' What does not count: 'Independent private duty work is not considered reportable employment.' Extra paperwork for agency and non-facility employers: 'Nurse aides who work for a staffing agency must submit a letter from their employer validating eight hours of employment as a nurse aide or performing nurse aide-related duties with their renewal application', and for staffing agencies or in-home care 'the nurse aide must complete the renewal application and have the non-facility based employer verify the nurse aide worked at least eight hours performing paid nurse aide duties within the two years since the last renewal.' Notice and process: 'At least 60 days before the nurse aide's registration expiration date, the OHFLAC-NAP will send either an electronic notice or a reregistration application with instructions to the nurse aide through the U.S. mail to his or her last known address', the aide returns the application 'prior to the expiration date', and 'When all requirements are met, the OHFLAC-NAP will send a letter to the nurse aide informing him or her of renewal for another two years.' The duty is personal: 'Completion of the re-registration application is the responsibility of the applicant and not the facility or employer.' The online renewal form opens on the registration number and collects employment dates, employer name and address, job title and the specific duties performed, alongside a direct question about other states' abuse registries. Address and name changes go to OHFLAC in writing, with a photocopy of the legal document for a name change; OHFLAC also asks employers to 'validate the nurse aide's status on line using the OHFLAC web site prior to hiring.'",
   "ce_hours": "None, and West Virginia says so in a single sentence: 'There are no in-service or continuing education requirements related to maintaining an aide's status on the Nurse Aide Registry.' The renewal condition is eight hours of paid nurse aide work in the previous two years, and nothing else. The 12-HOUR annual in-service obligation that people hear about is the facility's, not yours, and OHFLAC keeps the two apart explicitly: 'However, facilities and agencies that employ nurse aides must comply with any applicable in-service requirements under federal regulations. Facilities are required to provide and document at least 12 hours of completed nurse aide in-service per year. In-service requirements are not tracked by the Registry, but are enforced through the OHFLAC Nursing Home Program.' So a nurse aide's registry status is unaffected by whether the employer meets its in-service duty, and vice versa. Sources checked: the OHFLAC Nurse Aide Program Policy Manual in full (62 pages), 71 CSR 18 in full, the OHFLAC nurse aide program page, the online renewal application and the contracted vendor's Sponsor/Candidate Handbook. The one place education re-enters is remedial rather than periodic: a refresher course of at least 16 hours is required of aides returning after a gap, mandated to retrain, or issued an alternative sanction — see the lapse and reinstatement details on this page.",
   "exam": "Two parts on the same day: a written (computer-based) examination and a skills performance evaluation. You must pass both. Written — 'The exam consists of 100 multiple choice questions. You will have ninety (90) minutes to complete the exam once you have started', with a paper-and-pencil fallback 'If technical difficulties are encountered'. Passing scores, from OHFLAC's policy manual rather than the vendor: 'The written portion has 100 points possible with a minimum passing score of 70 points. The skills portion has a possibility of 300 points with a minimum passing score of 225.' Skills — 'You have thirty (30) minutes to perform five (5) nursing assistant skills, initial steps, and completion steps. These skills are selected from the complete skills listed in the West Virginia NURSE AIDE PROGRAM POLICY MANUAL-Appendix:F', rated by 'A trained Registered Nurse, trained as an evaluator'. The 'resident' is played by an actor. You may correct yourself: 'Tell the evaluator if you make a mistake and you will be allowed to go back and begin from where you feel you made the mistake.' Four ways to fail the skills outright, per the manual: you 'Cannot perform any part of the skill'; you tell the rater you did not learn the skill; you do not perform the critical steps in one or more skills; or you 'Put the resident at risk for injury.' The vendor states the same rule from the candidate's side: 'If you refuse to perform a particular skill or state that you do not know how to perform a skill, you will fail the exam regardless of the number of points you have accumulated.' Oral version — available on request and only on paper: 'The oral test will be given in the English language by a reader or computer recording. Each question and answer will be read twice. The oral version also has 100 multiple choice questions and is the same written exam being administered to the other candidates.' The manual adds that 'The oral version shall include a written section to determine the ability of the candidate to read and understand job-related duties and information.' Other languages need the state's permission, not the vendor's: 'For the test to be offer in any language other than English, you must submit a request to the West Virginia Nurse Aide Registry.' Attempts and windows — three attempts, then retrain: 'Each candidate will have three (3) opportunities to pass the competency evaluation. If a candidate is unable to pass the competency evaluation after three (3) attempts, the candidate will be required to complete another full nurse aide training program. Upon completion, the candidate is eligible for three (3) more opportunities.' The outer limit is two years: 'All individuals must successfully complete the competency evaluation within 24 months of graduation from an approved education program, unless that individual challenges the training program (RN/LPN Challenge). In that instance, the individual has six (6) months to complete the competency evaluation.' Practicalities that trip candidates up: applications and correct fees must reach the vendor at least two weeks before the requested test date; rescheduling requires notice 'by noon at least five (5) business days before the examination date'; a no-show forfeits the fee and it cannot be transferred; candidates must bring the admission ticket, current photo ID and an original unaltered Social Security card, plus 'A watch with a second hand, electronic watches not permitted'; and a candidate who is pregnant or has been excused from work by a physician must send a release 'stating NO RESTRICTIONS' in advance — 'If you are too sick or injured to work, you are too sick or injured to take the exam.' Preliminary results come the same day; 'Final results will be posted on the PHD web site within one business day.'",
   "fees": "West Virginia publishes no state fee for nurse aide registration, renewal or reciprocity. The Nurse Aide Program Policy Manual contains no fee schedule, the online renewal, reciprocity and RN/LPN Challenge applications carry no payment step, and OHFLAC has retired the nurse aide page that once answered this question: as of August 16, 2026 the 'Associated Fees' address returns 'not found', seven of the eight pages listed beside it do the same, and the menu that linked them no longer appears on OHFLAC's own nurse aide page at all. That is a section the agency has taken down, not a page that happened to be unavailable — so the absence of a state fee is not a hole in what could be read. Checked across the policy manual in full, the three online application forms, the OHFLAC nurse aide program page and the third-party vendor page, and no state charge for a nurse aide appears in any of them. The cost is the examination, and it is paid to the state's contracted vendor. Published fees: 'Written and Skills $140.00; Oral Exam $180.00; Written Exam $55.00; Skills Performance $85.00; Oral $90.00.' A first-time candidate takes both parts on the same day and pays for both — $140 for the written-plus-skills combination, or $180 if the oral version replaces the written. Retesting a single part costs that part's fee. Refunds are narrow: 'Refunds will be charged a $35.00 processing fee and must be requested prior to 5 business days of testing date; no transfer of fees.' A no-show pays again in full: the reschedule fee 'is the same as a first time test taker', and 'The facility where you work is not responsible for paying your \"NO SHOW\" reschedule fee.' Payment method: 'facility check, money order, credit/debit Card. NO personal checks or cash will be accepted', and 'EXAM REGISTRATIONS WILL NOT BE PROCESSED UNLESS PAYMENT IS RECEIVED AT THE TIME OF APPLICATION.' Who actually pays: for an employed candidate, the employer — federal law bars charging any portion of the training programme to a nurse aide who was employed by or held an offer from a facility when the programme began, and 'If an employee is attending class at a non-facility-based program which charges a fee, the facility, not the employee, must pay that fee.' Tuition is not set by the state and is not published by OHFLAC. Note that a registry-status printout is free: the state's own verification page produces the 'OFFICIAL VERIFICATION' and registration number that candidates and employers need, at no charge.",
   "legal_basis": "[{\"citation\": \"West Virginia Code of State Rules, Title 71, Series 18 (Office of Inspector General — Nurse Aide Abuse and Neglect Registry), filed and effective May 28, 2025, sunset August 1, 2030\", \"what_it_governs\": \"The rule that defines who a nurse aide is in West Virginia law, what a test-eligible nurse aide is and the four-month limit on that status, the aide's personal duties including reporting and appearing under subpoena, the facility's immediate and five-day reporting duties, the investigation and determination process, the notice and 30-day hearing right, the Board of Review hearing and the appeal to the Intermediate Court of Appeals, and the placement rules — permanent for abuse, one calendar year for neglect with time added for working through it. Section 1.2 gives its authority as W. Va. Code 16B-3-8 and 16B-4-5; section 1.1 directs that it 'be read in conjunction with W. Va. Code 9-6-1, et seq.; 16B-3-1, et seq.; 16B-4-1, et seq.; and 42 CFR 483.13(b), 483.156 and 488.301.' This rule was reassigned from 69CSR6 — the filing memorandum records 'the reassignment of Legislative Rule 69CSR6 to 71CSR18', along with an updated authorizing code citation and updated references to the former Department of Health and Human Resources.\", \"url\": \"https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=18213\"}, {\"citation\": \"W. Va. Code 16B-4-5 (Rules; minimum standards for nursing homes) and W. Va. Code 16B-3-8 (Inspector General to establish standards; director enforces), both as enacted by 2024 Regular Session SB 300\", \"what_it_governs\": \"The statutory authority the nurse aide rule cites. Section 16B-4-5(d) contains the one nurse-aide-specific command in either section: 'The director shall permit the nonclinical instruction portions of a nurse aide training program approved by the Office of Health Facility Licensure and Certification to be provided through distance learning technologies.' Section 16B-3-8 supplies the enforcement designation the rule repeats: 'The Inspector General designates the director of the Office of Health Facility Licensure and Certification to enforce the provisions of this article, except where otherwise stated.' Both sections sit in Chapter 16B (Inspector General), which is where health facility licensure moved under SB 300 in 2024.\", \"url\": \"https://code.wvlegislature.gov/16B-4-5/\"}, {\"citation\": \"42 CFR Part 483 — Requirements for Long Term Care Facilities, including 42 CFR 483.13(b), 483.151, 483.152, 483.156 and 488.301; and the Omnibus Budget Reconciliation Act of 1987 with its 1990 and 1999 amendments, 42 U.S.C. 1396r(f)(2)\", \"what_it_governs\": \"The federal frame the whole West Virginia programme implements. OHFLAC states it directly: 'The NATCEP was established under the federal Omnibus Reconciliation Act (OBRA) of 1987, 1990, and 1999. This Act requires states to establish a NATCEP and maintain a long-term care nurse aide registry.' The state rule cites the CFR sections by number, OHFLAC links 42 CFR 483 from its own nurse aide page as the controlling federal requirement, and the manual cites 42 U.S.C. 1396r(f)(2) as the basis for waiving the two-year prohibition on a facility-based training programme. The federal texts are cited here because West Virginia's own rule and manual rest on them; nothing on this page quotes them directly.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483\"}, {\"citation\": \"W. Va. Code 16-49-1 et seq. and 69 CSR 10 (West Virginia Clearance for Access: Registry and Employment Screening — WV CARES), and W. Va. Code 9-6-1 et seq. (Adult Protective Services), 16-5L-1 et seq. (long-term care ombudsman), 29A-5-1 et seq. (contested cases) and 69 CSR 1 (Office of Inspector General hearing procedures)\", \"what_it_governs\": \"The surrounding machinery the nurse aide scheme depends on: the fingerprint-based background screening system OHFLAC describes ('The laws governing this program are found in W.Va. Code 16-49-1 et seq. and 69CSR10'); the Adult Protective Services reporting duty that facility staff owe alongside the OHFLAC report; the ombudsman notification; and the administrative-hearing framework under which the Board of Review hears a nurse aide's challenge to an abuse or neglect finding. None of these texts is quoted here. Each is named because West Virginia's own rule or manual names it, and nothing on this page rests on their contents beyond the descriptions above.\", \"url\": \"https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=18213\"}]",
   "exam_vendor": "Professional Healthcare Development, LLC (PHD) of Ona, West Virginia — the state's contracted vendor, named by OHFLAC on its own third-party vendor page: 'Professional HealthCare Development (PHD) will be the contracted vendor for Nurse Aide and AMAP testing, as well as the Educate the Educator Workshop and the Refresher Course Workshop for West Virginia. OHFLAC will work closely with PHD to ensure they are able to begin providing services expediently. To schedule testing you may contact PHD.' West Virginia therefore uses no national vendor examination — there is no NNAAP form, no Credentia and no Prometric here; the state contracts a single in-state provider that writes and delivers the test under OHFLAC's rules. The policy manual keeps the standards with the state and delegates only the delivery: 'The contracted vendor will administer the services as outlined in the contractual agreement with the OHFLAC.' A structural safeguard sits alongside it: 'The competency examination (both written and skills demonstration) must be administered and evaluated only by an approved entity which is neither the skilled nursing facility that participates in Medicare nor a nursing facility that participates in Medicaid.' Evaluator qualifications are fixed by OHFLAC, not by the vendor: 'The evaluator who conducts the competency evaluation of a student must be a registered nurse licensed to practice in WV and have a minimum of two years of experience working as a registered nurse, one year of which must be in the provision of long-term care.' Testing sites come in two kinds, both OHFLAC-approved — regional test sites, where 'The vendor contracts with the organization and pays a fee for the use of its facility', and in-facility test sites attached to a training program, where 'The department does not contract with the organization and does not pay a fee for the use of the facility.' The vendor's current published sites are Beckley, Buckhannon, Milton, Martinsburg, Parkersburg, Keyser, Glen Dale and New Cumberland.",
   "training_hours": "120 clock hours minimum, of which at least 55 must be instructor-supervised clinical practice — and the course must run at least four weeks. OHFLAC's Nurse Aide Program Policy Manual states all three in one paragraph: 'The minimum time required for a nurse aide training program is 120 clock hours. At least 55 of the 120 hours must be instructor supervised clinical practice. The remaining hours must be classroom instruction and skills development in the classroom laboratory. The length of a training course must be, at a minimum, four weeks.' Two things make this stand out. First, the 55-hour clinical floor is one of the highest proportions in the country — 46% of the total, against a federal framework that sets 75 total hours with 16 hours of instruction before direct resident contact and no fixed clinical share. Second, the four-week minimum duration is a rule most states do not have at all: it stops a program compressing 120 hours into a fortnight. What the hours must cover: the manual's Appendix E sets the minimum curriculum as Orientation, Communication and Social Interaction, Basic Nursing Skills, Personal Care Skills, Basic Restorative Services, Rights of Residents, and Dementia, and Appendix F carries the skills performance task list from which the state exam draws. 'Each nurse aide training program must be competency based.' Proof of each skill is individual, not cohort-wide: 'The primary instructor must individually record when a student satisfactorily performs each required task or skill and provide a copy of the student's performance record to the student ... When a student has satisfactorily completed all required skills and competencies, attained the necessary knowledge, and achieved the stated course completion criteria, the student qualifies to take the state competency test.' A separate, shorter course exists for re-entry: the refresher course 'is a minimum of 16 hours, but may be longer' and covers a condensed version of the full curriculum — see the lapse and reinstatement details on this page for who may take it. Note on the source: these figures come from OHFLAC's policy manual, which carries an effective date of May 2016 and is the document OHFLAC still links from its own Nurse Aide Program page; they do not appear in West Virginia's nurse aide legislative rule, which governs the abuse and neglect registry rather than the training programme.",
   "lapse_rule": "West Virginia grades the way back by how long you have been out of paid work, in three bands. Two to four years — refresher course: an applicant is eligible for 'The refresher course when there is no reportable work history between two to four years or since the most recent completion of NATCEP.' The refresher 'is a minimum of 16 hours, but may be longer', covers a condensed version of the full curriculum, and 'shall be offered by the contracted vendor or any approved NATCEP instructor that is affiliated with an approved training program.' Three testing attempts follow, and 'All testing attempts following a refresher course must be completed six (6) months after class completion.' More than five years — full course: 'The full course when there is no reportable paid work in nurse aide-related employment in the past five years.' Note the gap in the state's own wording between four and five years, which the manual does not close. Who else may take the refresher: an aide who 'Has lost registry status due to the lack of, or inability, to fulfill federal requirements', who 'Has failed to reregister within the allowed time frame', who 'Has been mandated to retrain in certain areas', or who 'Has been issued an alternative sanction by the OHFLAC-NAP instead of a stricter penalty' — and for the last two categories the clock is tight: 'Nurse aides who qualify under #3 or #4 of the above list must complete the refresher course and pass the competency evaluation within 120 days from the issue date of the letter.' Alternative-sanction retraining is at the aide's own cost: 'All expenses related to the retraining are solely the responsibility of the nurse aide.' The registry entry itself ages out at 24 months: 'The registry will remove entries for individuals who have performed no nurse aide duties or nursing related services for a period of 24 consecutive months, unless the individual's registry entry includes documented findings of abuse, neglect, or misappropriation of property.' A completely different and far harsher track is the abuse and neglect registry. Placement for abuse is permanent — '71-18-11.1. Placement on the Nurse Aide Registry for any type of abuse is permanent.' Placement for neglect runs one calendar year, after which 'the nurse aide may send a written request to the Registry to have his or her name removed', but with a penalty for working through it: if the aide 'has continued to work in long term care, assisted living, behavioral health or hospice after he or she has been notified', that time is 'added to the placement time so that a total of one calendar year is served.' The consequence reaches well beyond nursing homes: 'Individuals whose names are listed on the Nurse Aide Abuse and Neglect Registry are no longer eligible to work in skilled nursing facilities, nursing facilities, home health agencies, hospice care providers, long-term care hospitals, personal care services providers, adult day care providers, assisted living facilities, intermediate care facilities for individuals with intellectual disabilities, and certain other health care facilities.' Due process: OHFLAC investigates, notifies by certified mail, and states its 'intent to place the individual's name on the Nurse Aide Abuse and Neglect Registry in 30 days if the individual fails to request a hearing or fails to agree to alternative sanctions'; the aide has 30 days to request a hearing before the Board of Review, which must be scheduled within 120 days; 'The Office of Health Facility Licensure and Certification bears the burden of proof by a preponderance of the evidence'; the aide bears the cost of counsel and any transcript; the hearing is closed to the public; and an appeal lies 'within 30 days to the West Virginia Intermediate Court of Appeals'. Two automatic entries exist: an out-of-state registry placement is mirrored into West Virginia's (71 CSR 18-7.5), and a court determination of abuse, neglect or misappropriation 'in any case involving a minor or an incapacitated adult shall result in placement' (71 CSR 18-9).",
   "reciprocity": "West Virginia will take a transfer from another state's registry, but it applies two tests — an equivalence test and an unusual three-year work test. OHFLAC's own reciprocity page states both: 'Individuals who are listed on the registries of other states which have requirements substantially the same as the West Virginia requirements for education and competency evaluation may apply for inclusion in the West Virginia Nurse Aide Registry. The listing of the individual on the West Virginia registry will depend upon the individual's acceptable standing on the registry of the other state and if there is not a twenty-four (24) month lapse in paid RNA employment within the past three years.' That second condition is the one to read twice: the look-back is three years, and what disqualifies is any 24-month gap inside it — a stricter and differently shaped rule than the simple 'currently active' test most states use. The policy manual states the equivalence side in the same terms: 'Individuals who are listed on other states' registries must be in good standing and the other states' requirements must be substantially the same as the West Virginia requirements for education and competency evaluation in order to apply.' A flat rule on where training happened: 'All training must be done in the United States' — so a foreign-trained applicant cannot reciprocate in. How to apply: through OHFLAC's online Application by Reciprocity, which collects the out-of-state training program's name and address, the training completion date, the registration date, and every state registry held or previously held with its registration number, plus the question 'Are you currently on another state's nurse aide registry for abuse, neglect, or misappropriation of resident property?' The policy manual also refers to a paper Request for Reciprocity Form (WVNATCEP-5), and states that 'The NATCEP office will request reciprocity from another state upon receipt of a completed' form — West Virginia does the verifying, not the applicant. Going the other way, OHFLAC gives three steps: make sure your West Virginia employment eligibility status is current; 'Contact the transferring state's registry and inquire about that state's requirements'; and complete that state's application. And a useful detail for travelling aides: 'A nurse aide may maintain employment eligibility to work in West Virginia by reporting their out-of-state employment to the OHFLAC-NAP.' Checked and not published: any reciprocity fee, and any processing time.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"West Virginia OHFLAC — Nurse Aide Program (the programme's landing page). Establishes the programme's structure and links: general information, the Nurse Aide Educational Program, AMAP, and the four online services — Nurse Aide Verification, Registration Renewal, Registration by Reciprocity and RN/LPN Challenge. Carries the Nurse Aide/AMAP Programs office address (1 Players Club Dr., Suite 301, Charleston, WV 25311), phone (304) 558-0050 and email ohflacnap@wv.gov.\", \"url\": \"https://ohflac.wvdhhr.org/Programs/NA.html\"}, {\"label\": \"West Virginia OHFLAC — Nurse Aide Program Policy Manual (effective May 2016, 62 pages, PDF), the document OHFLAC links from its own nurse aide pages. The source of almost every operational figure on this page: the 120-clock-hour minimum with at least 55 hours of instructor-supervised clinical practice and the four-week minimum course length; the OBRA framing and OHFLAC-NAP's four coordinating duties; the programme approval, monitoring and two-year facility prohibition rules; the record-retention and certificate-of-completion requirements; the no-charge rule for employed students and the 12-month Medicaid reimbursement to the first employing facility; the registry's contents and the 24-month inactivity purge; the reciprocity equivalence test; the transfer-out steps; the reportable-employment settings and the exclusion of independent private duty; the two-year re-registration cycle with eight hours of paid employment and the 60-day notice; the three-attempt limit and the 24-month (or six-month for RN/LPN challenge) testing window; the 16-hour refresher course, its eligibility categories and its 120-day and six-month clocks; the two-to-four-year and five-year retraining bands; the four-month facility employment limit; 'There are no in-service or continuing education requirements related to maintaining an aide's status on the Nurse Aide Registry' alongside the facility's 12-hour annual in-service duty; the WV CARES description; the competency-evaluation scoring (100 points written with 70 to pass; 300 points skills with 225 to pass); the four automatic-fail conditions; the evaluator qualifications; and the regional versus in-facility test site rules.\", \"url\": \"https://ohflac.wvdhhr.org/Content/Resources/NA-Policy_Manual.pdf\"}, {\"label\": \"West Virginia Code of State Rules, 71 CSR 18 — Nurse Aide Abuse and Neglect Registry, final file, filed and effective May 28, 2025 (Office of Inspector General). Establishes the definitions of nurse aide/nursing assistant and test-eligible nurse aide with the four-month working limit, the definitions of abuse, neglect, emotional/physical/sexual/verbal abuse, involuntary seclusion and misappropriation, OHFLAC's place within the Office of Inspector General, the aide's seven personal responsibilities, the facility's immediate and five-day reporting duties and the Adult Protective Services and ombudsman notifications, the investigation elements, the determination and notice provisions with the 30-day hearing right, the Board of Review hearing rules including the preponderance standard and the closed hearing, the appeal to the West Virginia Intermediate Court of Appeals, the mirroring of out-of-state registry placements, the facility's duty to give every aide a copy of the rule, and the placement rules — 'Placement on the Nurse Aide Registry for any type of abuse is permanent' and the one-calendar-year neglect placement with time added for continuing to work.\", \"url\": \"https://apps.sos.wv.gov/adlaw/csr/ruleview.aspx?document=18213\"}, {\"label\": \"West Virginia OHFLAC — Third-Party Vendor. Names the contracted testing vendor: 'Professional HealthCare Development (PHD) will be the contracted vendor for Nurse Aide and AMAP testing, as well as the Educate the Educator Workshop and the Refresher Course Workshop for West Virginia', with the vendor's address (P.O. Box 399, Ona, WV 25545), phone (304) 733-6145 and website, and the direction that AMAP questions go to 'OHFLAC Nurse Aide program at 304-558-0050, Option 1.'\", \"url\": \"https://ohflac.wvdhhr.org/thirdpartyvendor.html\"}, {\"label\": \"West Virginia OHFLAC — Nurse Aide Verification (the public registry lookup). Establishes the tool's purpose ('to assist employers and the public in expediting the verification of the status of a nurse aide in the state of West Virginia') and its two search methods — by name (first and last) or by state-assigned registration number.\", \"url\": \"https://ohflac.wvdhhr.org/Apps/Lookup/NALookup\"}, {\"label\": \"West Virginia OHFLAC — RNA Reciprocity (Nurse Aide Educational Program, Criteria & Guidelines). The source of the three-year work test: 'Individuals who are listed on the registries of other states which have requirements substantially the same as the West Virginia requirements for education and competency evaluation may apply for inclusion in the West Virginia Nurse Aide Registry. The listing of the individual on the West Virginia registry will depend upon the individual's acceptable standing on the registry of the other state and if there is not a twenty-four (24) month lapse in paid RNA employment within the past three years.' Also names the paper Request for Reciprocity Form (WVNATCEP-5) and establishes that OHFLAC requests the verification from the other state.\", \"url\": \"https://ohflac.wvdhhr.org/NA/reciprocity.html\"}, {\"label\": \"West Virginia OHFLAC — Nurse Aide Registration Renewal Application (online form). Establishes what re-registration collects: registration number, applicant identity and mailing address, the name-change documentation rule ('a copy of your marriage license, divorce decree and/ or social security card must be provided ... Send Documents By Mail/Fax (within 30 days)'), healthcare employment with dates, employer name and address, job title and private-pay flag, the duties performed (activities of daily living, assist with ambulation, catheter care, dental care, feeding, height/weight, transfer/lifting, vital signs), space for additional employment, and the question 'Are you currently on another state's nurse aide registry for abuse, neglect, or misappropriation of resident property?'\", \"url\": \"https://ohflac.wvdhhr.org/Apps/Forms/NARenewal\"}, {\"label\": \"West Virginia OHFLAC — Application for Nurse Aide Registration by Reciprocity (online form). Establishes the transfer-in data set: applicant identity and Social Security number, the out-of-state training program's name and address, the date of training completion and the date of registration, every state registry held with its registration number, and the abuse-registry question.\", \"url\": \"https://ohflac.wvdhhr.org/Apps/Forms/NAReciprocity\"}, {\"label\": \"West Virginia OHFLAC — Nurse Aide RN/LPN Challenge Application (online form). Establishes the challenge route's data set — applicant identity, school name and program address, start date of courses and 'Completion Date of Fundamentals of Nursing' — the Social Security number disclosure notice under W. Va. Code 48-18-133 and 42 U.S.C. 666, and the applicant's undertaking to 'submit transcripts and a letter from an instructor separate from this application to the Office of Health Facility Licensure and Certification Nurse Aide Program.'\", \"url\": \"https://ohflac.wvdhhr.org/Apps/Forms/RNLPNChallenge\"}, {\"label\": \"Professional Healthcare Development, LLC — Sponsor/Candidate Handbook, Registered Nursing Assistant (October 2025, PDF), published by the vendor OHFLAC names as its contracted testing provider. Establishes the exam fees (Written and Skills $140.00; Oral Exam $180.00; Written Exam $55.00; Skills Performance $85.00; Oral $90.00), the $35.00 refund processing fee and no-transfer rule, the payment methods and the rule that registrations are not processed without payment, the two-week application deadline and admission-ticket process, the five-business-day rescheduling rule and no-show forfeiture, the eight current test sites, the required items including 'A watch with a second hand, electronic watches not permitted', the no-restrictions medical release rule, the requirement to submit the OHFLAC test-eligible printout, the written exam's 100 multiple-choice questions and 90 minutes with a paper fallback, the oral version's identical 100 questions read twice, the requirement that other-language testing be approved by the West Virginia Nurse Aide Registry, the skills evaluation's five skills in thirty minutes with an actor playing the resident, same-day preliminary results with final results posted within one business day, and the retest rule that failing to pass both portions within two years or three attempts requires retaking a NATCEP.\", \"url\": \"https://www.profhd.com/Sponsor-Candidate%20Handbook2025.pdf\"}, {\"label\": \"Professional Healthcare Development, LLC — home page, the vendor site OHFLAC links from its third-party vendor page. Establishes the available candidate materials: the Nurse Aide Test Application and other forms, the candidate's eligibility checklist, the Sponsor/Candidate Handbook, the Nurse Aide Refresher Course information and application, the performance skills and skills checklist, the sample test, the Educate the Educator workshop information, the test sites and driving directions, the nurse aide test dates, and the test results page.\", \"url\": \"https://www.profhd.com/\"}, {\"label\": \"West Virginia Code 16B-4-5 (Rules; minimum standards for nursing homes), West Virginia Legislature. Establishes the distance-learning permission for the nonclinical portions of an OHFLAC-approved nurse aide training programme, and the resident-rights minimum standards the Inspector General's rules must contain. Bill history shows the section as enacted by 2024 Regular Session SB 300.\", \"url\": \"https://code.wvlegislature.gov/16B-4-5/\"}, {\"label\": \"West Virginia Code 16B-3-8 (Inspector General to establish standards; director enforces), West Virginia Legislature. Establishes the enforcement designation the nurse aide rule repeats: 'The Inspector General designates the director of the Office of Health Facility Licensure and Certification to enforce the provisions of this article, except where otherwise stated.'\", \"url\": \"https://code.wvlegislature.gov/16B-3-8/\"}, {\"label\": \"West Virginia OHFLAC — Nurse Aide Registry facility-type page (the Nurse Aide Registry entry in OHFLAC's facility-type index). Establishes the programme's own index of resources and rules, including the identification of 71-18 'Nurse Aide Abuse Registry' as the governing West Virginia Code of State Rules entry, the link to 42 CFR 483 as the governing federal requirement, and the note that OHFLAC lists no West Virginia Code chapter for this facility type.\", \"url\": \"https://ohflac.wvdhhr.org/factype.html\"}]",
   "page_url": "https://licensingatlas.com/cna/wv-cna/"
  },
  {
   "page_id": "wy-cna",
   "state": "Wyoming",
   "occupation": "Certified Nursing Assistant",
   "cluster": "cna",
   "credential_holder": "individual",
   "licensing_level": "",
   "board_name": "Wyoming State Board of Nursing (WSBN) — the agency that certifies the individual, under the Wyoming Nurse Practice Act. Two agencies share this credential in Wyoming: the Board issues and renews the CNA certificate, while the Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys approves CNA training programs and maintains the Wyoming CNA Registry used by nursing homes and swing beds. The Board states the split itself: 'The Wyoming Department of Health oversees CNA education programs.'",
   "board_url": "https://wsbn.wyo.gov/licensing",
   "application_url": "https://wsbn.wyo.gov/licensing",
   "renewal_cycle": "Every even year, expiring 31 December — the whole state renews on the same clock rather than on individual anniversaries. Board Rules ch. 2 § 2(x) defines the cycle: 'Renewal cycle means the period for meeting competency for renewal of licensure or certification which is from January 1st of every odd year to December 31st of every even year.' Section 8 sets the mechanics: 'The Board shall make application(s) for renewal of licensure and certification available on the Board website on or before October 1st of every even year', and a CNA seeking renewal shall 'Submit completed renewal application and fees' and 'Submit evidence of meeting competency under Section 14.' Section 9(a): 'All licenses and certificates expire on December 31st of the renewal year.' The Board has described the window in practice as running 'October 1 ... through December 31' and requiring completion 'through the nurse portal.' The Board puts the risk on the holder: 'Failure to receive a renewal notice from the Board does not excuse an APRN, RN, LPN/VN, or CNA from the requirements for renewal' (ch. 2 § 8(b)). The statute requires biennial renewal and conditions it on competency plus fees (Wyo. Stat. Ann. § 33-21-129(a) and (b)). A first certificate is often short: 'Your initial certificate may not be a full two (2) years, depending on when you get issued during the two (2) year period' — and the Board warns applicants of the same thing from the other direction, that 'you will have to apply again if you are getting your initial license in an even year.' Inactive status is an alternative to lapsing: the Board may grant inactive or retired status, the holder 'shall not practice nursing in this State until the license or certificate is reactivated', and 'A biennial renewal fee shall be required to retain the inactive status' — $30 (Wyo. Stat. Ann. § 33-21-131; ch. 2 § 12; ch. 5 § 4(k)). Reactivation costs $50 for a CNA and requires a new application, fresh fingerprint cards and competency evidence. Nurse aides carrying misconduct restrictions on the registry are not eligible to renew.",
   "ce_hours": "No fixed continuing-education mandate — Wyoming lets work, education or the exam satisfy the same requirement. Board Rules ch. 2 § 14(e), the current version of the rule (chapter effective 17 December 2025): 'A CNA shall demonstrate continuing competency by completing one of the following in the past two (2) years: (A) Four hundred (400) hours of employment in the CNA role; or (B) Forty (40) hours of continuing education; or (C) Successfully pass the NATCEP or similar national exam.' One of the three, not all three. The rule defines what it is testing for: continuing competency for a CNA is 'the ongoing ability of a CNA to maintain, update and demonstrate sufficient knowledge, skills and qualifications necessary to practice safely and ethically in the designated role and setting in accordance with the role of the CNA. A CNA achieves continuing competency through employment in the CNA role and continuing education' (ch. 2 § 2(d)). The same competency showing is required not only at renewal but for endorsement, reactivation, reinstatement and relicensure, measured 'during the timeframe identified prior to date of application' (ch. 2 § 14(b)). Whose courses count: the Board approves no continuing education itself — 'The WSBN does not offer approval of educational programs. Wyoming is willing to accept courses approved by continuing nursing education (CNE), continuing medical education (CME), or activities sponsored by organizations, agencies, or educational institutions. These courses are approved for nursing or medical contact hours by an accredited provider or approver of continuing education', and it publishes a list of examples of accrediting bodies. What the record must show: 'Your Name; Name of in service (the organization that offered the CEU); Date; How many credits the course was worth.' The Board may audit — 'The Board may conduct audits to verify competencies as outlined in Section 14', and on request holders 'shall submit documentation of compliance' (ch. 2 § 16). ⚠ The vendor handbook still publishes the older, four-option version of this requirement (400 employment hours; or 200 employment hours plus 15 continuing education hours; or 30 continuing education hours; or pass the NATCEP), together with a five-year re-training rule. That handbook is dated August 2024 and the current chapter 2 took effect on 17 December 2025, so the rule above is the later statement; we therefore do not present the handbook's figures as current.",
   "exam": "Two parts, and you must pass both. The state-linked candidate handbook states the structure: 'The examination has two parts: a multiple-choice knowledge test and a skill test. Candidates must pass both parts to be identified and listed on the Wyoming Nurse Aide Registry.' Knowledge test: 'The Knowledge Test consists of 60 multiple-choice questions. Questions are selected from subject areas based on the Wyoming State Board of Nursing approved Wyoming test plan and include questions from all the required categories as defined in the federal regulations.' The published subject-area distribution totals sixty: Role and Responsibility 9, Basic Nursing Skills 8, Disease Process 7, Resident Rights 6, Safety 6, Communication 5, Infection Control 4, Mental Health 4, Personal Care 4, Care Impaired 3, Aging Process and Restorative Care 2, Data Collection 2. 'You will have a maximum of 60 minutes to complete the 60-question Knowledge Exam. You will be told when fifteen (15) minutes remain', and 'You must have a score of 76% or better to pass the knowledge portion of the exam.' An audio version is available, in which the questions and answers 'are read through the computer, so you can listen to them through headphones or earbuds while you read along', and a remotely proctored option exists for the knowledge test, with check-in in a video waiting room 10 to 20 minutes before the start time. Foreign-language paper word-for-word translation dictionaries are permitted if shown at check-in. Skill test: one mandatory task with hand washing embedded comes first — assisting a resident with a bedpan, catheter care for a female resident, a PPE-and-urinary-drainage-bag sequence, or perineal care for a female resident — and 'You will also receive an additional two (2) or three (3) randomly selected tasks from the Skill Task listing.' Catheter care and perineal care are demonstrated on a manikin and the rest on a live resident actor. Scoring: 'To pass the skill component of your competency evaluation, you must score 80% on each task without missing any key steps (the bolded steps)', and 'To receive credit, you must actually perform and demonstrate every step during your skill test demonstration.' A candidate may tell the RN Test Observer they want to correct a step and then demonstrate it again. Both the knowledge and skill tests are taken on TMU at approved Wyoming test sites, and an RN Test Observer records the skills demonstration while the vendor's scoring team scores it. Attempts are capped at five, and the CAP is in the rule, not just the handbook. Board Rules ch. 2 § 3(c)(iv)(B): 'An applicant may sit for the NATCEP or similar national exam no more than five (5) times within the two (2) year period following graduation.' The handbook states the consequence: 'If you fail five attempts on either the knowledge or skills test component, you must complete a new Wyoming State Board of Nursing (WSBN) approved training program', and adds that a candidate who exhausts the attempts can no longer be employed under the trainee window. The statute requires the Board to set such a cap: 'The board shall by rules and regulations limit the number of reexaminations which may be taken by the applicant after the initial failure of a board approved national nursing licensure or nursing assistant certification examination' (Wyo. Stat. Ann. § 33-21-128(c)). A test-result review may be requested, subject to a $25 deposit fee described by the vendor. Removal from a test event for using a recording device or navigating to other browsers means the exam is 'scored as a failed attempt', fees are forfeited, and 'You will not be allowed to retest without clearance from WSBN.'",
   "fees": "Two separate bills: the Board's fees, and the testing vendor's fees. Board fees, from the fee rule effective 26 May 2026 (Board Rules ch. 5 § 4): Certification by Examination — CNA $60; Certification by Endorsement — CNA $60; DCI Background Check $60; Temporary permit $25; Renewal — CNA $50; Relicensure/Recertification/Reinstatement — CNA $60; Reactivation — CNA $50; Inactive/Retired certification $30; Verification of Licensure & Certification $25; Name Change $20; Pre-Application Determination $15; and $5 each for the initial CNA II, Medication Aide-Certified, Home Health Aide and LPN/VN IV certifications. Multistate licensure application processing is $0, and that line belongs to nurses rather than CNAs. The Board's own CNA checklist quotes the combined figure: 'Examination —Required Documents— Fee $120.00 (Add $25 if Temporary needed)', and the same $120 for endorsement — which is the $60 certification fee plus the $60 background check. Card processing is extra: 'There is a 2.4% processing fee with all card payments and a minimum fee of $1.' Every Board fee is nonrefundable except under the narrow refund rule for an application submitted for the wrong license type, which is refunded 'subject to a $25 refund processing fee' with a $5 minimum refund (ch. 5 § 3(b), § 4(r)). ⚠ A renewal-fee waiver applies in the 2026 renewal window — whether it reaches CNA certificate holders is addressed below. The fee rule carries a temporary provision: 'Notwithstanding any other provision in this chapter, licensees shall not be subject to fees specified in Section 4(f) and Section 4(g)(ii) from October 1, 2026, through December 31, 2026' (ch. 5 § 3(c)). Section 4(f) is the renewal schedule, and its own list carries the CNA renewal at $50. One word in that provision is unsettled and this site will not resolve it: the waiver runs to 'licensees', and Wyoming's nursing act ordinarily keeps the two populations apart — Wyo. Stat. Ann. § 33-21-120(a)(viii) defines 'License' as 'a current document permitting the practice of nursing as an advanced practice registered nurse, registered nurse or licensed practical nurse', which does not include nursing assistants, while § 33-21-120(a)(v) gives them a separate 'Certificate', and the Act writes 'licensees or certificate holders' wherever it means both (§§ 33-21-130, 33-21-131 and 33-21-153(a)). Board Rules ch. 5 has no definitions section and ch. 2 § 2 defines no 'licensee'. So the cross-reference to Section 4(f) reads as covering the CNA renewal line, while the word 'licensees' reads as excluding certificate holders. A CNA renewing in the October-to-December 2026 window should ask the Board which reading it is applying before assuming the fee is waived. The waiver is written to expire on 31 December 2026. Testing fees, paid to the vendor, from the Wyoming candidate handbook: Knowledge Exam or Knowledge Retake $32.00; optional Audio Knowledge Exam or Audio Retake $42.00; Skill Test or Skill Retake $95.00 — so a candidate taking both parts once pays $127, and each retake is charged again at the same rate. Payment to the vendor is by Visa, MasterCard or debit card. Not a board fee: training-program tuition, and whatever a local law enforcement agency charges to take fingerprints, which the Board flags — 'some may charge a fee to do so.' Not charged to some candidates at all: the Department of Health's training-program application requires each program to explain 'how the program is meeting the requirement which prohibits charging of nurse aides who are employed or have an offer of employment by a nursing home', which is the federal rule at 42 CFR 483.152(c).",
   "legal_basis": "[{\"citation\": \"Wyo. Stat. Ann. §§ 33-21-119 through 33-21-157 (the Wyoming Nurse Practice Act)\", \"what_it_governs\": \"The definitions of 'Certificate' and 'Practice of a certified nursing assistant/nurse aide' (33-21-120(a)(v) and (a)(xii)); the Board of Nursing and its powers (33-21-121 through 33-21-126); qualifications for certification including the approved program, the national examination and the fingerprint-based criminal history check (33-21-127); the Board's authority to contract for the examination and its duty to cap reexaminations (33-21-128); biennial renewal and forfeiture on expiry (33-21-129); relicensure and recertification (33-21-130); inactive status (33-21-131); temporary permits and their ninety-day limit (33-21-132); education program approval (33-21-138 through 33-21-144); the title-protection and unlawful-employment offences (33-21-145); discipline (33-21-146 and 33-21-147); the employer duty to report terminated certificate holders (33-21-153); and the exemptions (33-21-154).\", \"url\": \"https://www.wyoleg.gov/statutes/compress/title33.pdf\"}, {\"citation\": \"Wyoming State Board of Nursing Rules, Chapter 2 — Licensure/Certification Requirements (Wyoming Administrative Rules reference 054.0002.2.12172025, effective 17 December 2025)\", \"what_it_governs\": \"The definitions of continuing competency for a CNA and of the renewal cycle (§ 2); the four requirements for CNA certification by examination and the five-attempts-in-two-years cap (§ 3(c)); the six requirements for certification by endorsement and the fallback to examination where verification is unsatisfactory (§ 4); the CNA II, Medication Aide-Certified and Home Health Aide add-on certifications, including the Home Health Aide's sixteen hours (§ 5); temporary permits (§ 7); biennial renewal and the October-of-even-year application date (§ 8); expiry and forfeiture (§ 9); relicensure after failure to renew (§ 10); the twelve-month application expiry (§ 11); inactive status and reactivation (§ 12); reinstatement after discipline (§ 13); the three continuing-competency options for a CNA (§ 14(e)); and the Board's audit power (§ 16).\", \"url\": \"https://drive.google.com/file/d/1LgXrM7pK_pGxFz7gxhu_pUOtTIKKucNI/view\"}, {\"citation\": \"Wyoming State Board of Nursing Rules, Chapter 5 — Fees (Wyoming Administrative Rules reference 054.0002.5.05262026, effective 26 May 2026)\", \"what_it_governs\": \"The complete fee schedule, including CNA certification by examination and by endorsement at $60 each, the $60 DCI background check, the $25 temporary permit, the $50 CNA renewal, the $60 recertification and $50 reactivation, the $30 inactive status, the $25 verification, the $20 name change, the $15 pre-application determination and the $5 add-on certifications; the nonrefundable-fees rule and its narrow wrong-license-type refund; and the temporary provision at § 3(c) suspending renewal fees from 1 October 2026 through 31 December 2026.\", \"url\": \"https://drive.google.com/file/d/1hddFhR9GIiPt3YXIicgrmE-QfA1ynWr_/view\"}, {\"citation\": \"Wyoming State Board of Nursing Rules, Chapter 3 — Scope and Standards of Nursing Practice and CNA Role (Wyoming Administrative Rules reference 054.0002.3.09072017, effective 7 September 2017)\", \"what_it_governs\": \"The definition of unlicensed assistive personnel as including CNAs (§ 2(e)); the role of the CNA and the requirement that the CNA work under the direction of an APRN, RN or LPN (§ 7); the treatment of CNA II, MA-C and LPN IV as expansions of an existing role (§ 8); and the standards, responsibilities and criteria of delegation and assignment, including the delegatee's own duties (§§ 9 through 11).\", \"url\": \"https://drive.google.com/open?id=1c-P1XnZ4KjE4QltPYNtZjXTMZkS1w6v5\"}, {\"citation\": \"42 CFR 483.152 (Requirements for approval of a nurse aide training and competency evaluation program)\", \"what_it_governs\": \"The federal minimums that operate in the absence of a Wyoming figure: no less than 75 clock hours of training, at least 16 hours of supervised practical training, at least 16 hours of specified subjects before any direct resident contact, the curriculum content, instructor qualifications, and the prohibition at 483.152(c) on charging a nurse aide who is employed by or holds an offer of employment from a nursing home for any part of the program. Cited because the Wyoming Department of Health links subpart D as the governing federal regulation on its CNA page and because its training-program application requires each program to show compliance with the no-charge rule.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "exam_vendor": "D&S Diversified Technologies, LLP (D&SDT) — Headmaster, LLP, operating Wyoming TestMaster Universe (TMU) at wy.tmutest.com. The Board names the vendor on its own education page — 'The Wyoming Nurse Aide testing services will be available on Headmaster's website located at D&S – Headmaster' and 'Virtual knowledge testing is available for CNA candidates' — and links the vendor's Wyoming candidate handbook from that page. The Department of Health's training-program application is blunter still: 'NOTE: Headmaster is the only approved facilitator in Wyoming.' The vendor's Wyoming page states the approval from the other side: 'D&SDT-Headmaster is honored to be approved by the Wyoming State Board of Nursing to offer Certified Nurse Aide Testing Services to the Wyoming Health Care Community.' This is a recent arrangement and older guides name the wrong vendor: the Board announced on 2 June 2023 that 'The contract with Prometric is through June 30, 2023, and the transition to the Headmaster contract is July 1, 2023', with the last Prometric test date 17 June 2023. Scheduling opened on the new system in July 2023. The vendor is named here because Wyoming names it; no vendor page is cited for any legal requirement on this page.",
   "training_hours": "Wyoming publishes no state minimum of its own — the operative floor is the federal one, and Wyoming's own sources point at it rather than restating it. Board Rules ch. 2 § 3(c)(i) requires only that the applicant 'Successfully complete a state approved CNA training and competency evaluation program', and the statute says the same in general terms: the nursing assistant 'shall complete a specified course of study approved by the board, meet minimum competency requirements and be certified by the board' (Wyo. Stat. Ann. § 33-21-120(a)(xii)) and shall 'Be a graduate of a state board approved nursing or nursing assistant education program recognized by the board' (§ 33-21-127(a)(ii)). Neither attaches a number. The Department of Health, which approves the programs, asks the program for its hours rather than prescribing them: its training-program application (HLS/CNA-101) has three consecutive blanks — '23. Length of the course in hours', '24. Number of hours of classroom instruction', '25. Number of hours of supervised practical training' — and states no minimum against which they are measured. The Department instead links the federal rule as the governing standard for nurse aide training and competency evaluation. The federal floor, in the regulation's own words: a nurse aide training and competency evaluation program must 'Consist of no less than 75 clock hours of training' and 'Include at least 16 hours of supervised practical training. Supervised practical training means training in a laboratory or other setting in which the trainee demonstrates knowledge while performing tasks on an individual under the direct supervision of a registered nurse or a licensed practical nurse' (42 CFR 483.152(a)(1) and (a)(3)), with 'At least a total of 16 hours of training' in communication and interpersonal skills, infection control, safety and emergency procedures including the Heimlich maneuver, promoting residents' independence, and respecting residents' rights 'prior to any direct contact with a resident' (483.152(b)(1)). Sources checked for a Wyoming hour figure and found silent: Wyo. Stat. Ann. ch. 21 of title 33 in full (the only hour figures anywhere in the chapter are three continuing-education hours for prescribers and a 48-hour patient-transport exemption); Board Rules chapters 1, 2, 3 and 5 in full (the only hour figures are the Home Health Aide's 16 hours, the continuing-competency figures, and the APRN provisions); the Department of Health's CNA page; the HLS/CNA-101 training program application; the Department's healthcare-facility rules index; and the Wyoming Nurse Aide Candidate Handbook. So the honest statement is that Wyoming sets no state figure above the federal minimum, not that Wyoming requires 75 hours as a matter of Wyoming law.",
   "lapse_rule": "Expiry is immediate and absolute, and practising past it is a disciplinary matter. Board Rules ch. 2 § 9: 'All licenses and certificates expire on December 31st of the renewal year'; 'Failure to renew the license/certificate on or before the date of expiration shall result in an expired license/certificate and the forfeiture of the right to practice nursing in the State until the Board reissues the license/certificate'; and 'Any APRN, RN, LPN/VN, or CNA who practices on an expired license shall be subject to discipline.' The statute says the same: 'Failure to renew the license or certificate by the expiration date shall result in forfeiture of the right to practice nursing or nurse assisting in this state' (Wyo. Stat. Ann. § 33-21-129(d)). No grace period appears in the statute, the rules or the Board's pages. Coming back is a three-part application, not a late fee. Ch. 2 § 10: an individual whose certificate is inactive by failure to renew shall 'Submit completed application and fees; Submit CBC fingerprint cards and fees; and Submit evidence of meeting competency under Section 14.' New fingerprint cards mean a fresh DCI check and its 15-to-30-day wait, and recertification costs $60 rather than the $50 renewal. The statutory authority is § 33-21-130. Re-entry after a long absence is the competency test, not a fixed clock. Wyoming does not publish a number of years after which a CNA certificate is unrecoverable; what it publishes is the competency requirement in ch. 2 § 14(e), which must be met 'during the timeframe identified prior to date of application' — so a CNA returning after several years satisfies it by 400 hours of CNA employment, 40 hours of continuing education, or passing the competency examination again. Note that the Board's separate statement that a refresher course 'is the only approved way to come back into licensure in the state of Wyoming' sits on its nurse-facing material and is tied to the RN and LPN refresher rule at ch. 2 § 14(d)(i)(C); the CNA option list in § 14(e) contains no refresher course. Reinstatement after discipline is a different and harder route: a CNA 'whose license or certificate has been revoked, surrendered, suspended, or conditioned' must additionally submit 'evidence of compliance with the previous Board's order or correction of underlying conduct' and 'evidence demonstrating just cause for reinstatement' (ch. 2 § 13). A misconduct restriction on the registry blocks renewal outright.",
   "reciprocity": "Certification by endorsement, with a hard fallback. Board Rules ch. 2 § 4(d) lists what a CNA endorsement applicant must do: '(i) Submit evidence of successful completion of a state approved CNA training and competency evaluation program; (ii) Submit verification of an active certificate from another jurisdiction; (iii) Submit completed application and fees; (iv) Submit CBC fingerprint cards and fees; (v) Submit verification of initial certification by examination; and (vi) Submit evidence of meeting competency under Section 14.' The fee is the same $60 as certification by examination, plus the $60 background check. The fallback is the first sentence of the section and it applies to every credential type: 'An applicant who is unable to provide satisfactory verification of education, training, or competency shall be required to meet the requirements for licensure or certification by examination' (ch. 2 § 4(a)) — that is, sit Wyoming's competency examination. How the verification travels: the Board publishes a CNA Verification Form and instructs that 'When you are moving TO Wyoming, from another state, you will need to apply via Endorsement, and fill out our verification forms IN ADDITION to your COMPLETED application.' Nursys, which handles RN and LPN verification, is not used for nurse aides. The state-linked candidate handbook adds an eligibility condition the rule does not state in those words: to endorse in you must be a CNA 'Who is certified in another state', 'Whose certification is current and in good standing', and 'Who has never been certified in Wyoming' — someone previously certified in Wyoming goes through recertification instead. A temporary permit can bridge the wait, requested with the endorsement application for $25, subject to the Board's criminal-history bar and its power to revoke at any time. Going the other way: 'When moving to a new state from Wyoming you will need to first CONTACT the state you are moving TO. No state has the same process for licensure so you will need to see what they will need in order for you to be licensed there', and Wyoming's part is done by returning the Verification Payment Form; verification costs $25. Wyoming's Nurse Licensure Compact membership does not reach CNAs — the compact covers RN and LPN/VN multistate licenses only, as its own definition says ('Multistate license means a license to practice as a Registered Nurse (RN) or Licensed Practical Nurse/Vocational Nurse (LPN/VN)', ch. 2 § 2(o)), so a CNA moving to Wyoming endorses individually.",
   "last_verified": "2026-08-16",
   "source_urls": "[{\"label\": \"Wyoming State Board of Nursing — Licensing. The core page. Establishes the Nurse Portal application route and 'Paper applications are no longer accepted and credit/debit card payments are the only form of payment accepted'; the capitalised instruction to apply and pay first; 'Wyoming does not provide paper licenses' and that a wall certificate or wallet card is not acceptable verification; the CNA checklist and the Verify a CNA link; the two-fingerprint-card requirement and the 15-to-30-day DCI processing time; 'There are NO automatic disqualifiers in the process' and 'There are no pre-disqualifiers in the state of Wyoming for licensure'; the 45-to-60-day overall timeline; the 2.4% card processing fee with a $1 minimum; the temporary permit rules including the 120-day CNA figure, the $25 fee and the five-year criminal-history bar; the continuing-education documentation requirements; and the Headmaster 'Schedule My CNA Test' link.\", \"url\": \"https://wsbn.wyo.gov/licensing\"}, {\"label\": \"Wyoming State Board of Nursing — Education. Establishes the division of labour on training — 'The Wyoming Department of Health oversees CNA education programs' — and the testing arrangement: 'The Wyoming Nurse Aide testing services will be available on Headmaster's website located at D&S – Headmaster' with virtual knowledge testing available through Wyoming TMU. Also lists the Wyoming colleges offering CNA certificates, links the Department of Health's approved-CNA-program list and the 'How to Become an Approved CNA I Training Program' route, links the approved CNA II and MA-C course lists, and states the Board's continuing-education posture: 'The WSBN does not offer approval of educational programs.'\", \"url\": \"https://wsbn.wyo.gov/education\"}, {\"label\": \"Wyoming State Board of Nursing — Announcements. Establishes the 14 July 2023 CNA temporary permit statement ('A CNA temporary permit (once issued) is valid for 120 days'; 'The temporary permit can not be issued without the initial CNA application'); the 2 June 2023 testing-vendor transition ('The contract with Prometric is through June 30, 2023, and the transition to the Headmaster contract is July 1, 2023', last Prometric test date 17 June 2023); the 11 July and 28 July 2023 announcements that virtual knowledge testing and full CNA scheduling were live on Wyoming TMU; the renewal-window description 'October 1, 2024 through December 31, 2024 and must be completed through the nurse portal'; and the 14 January 2026 notice that 'Chapter 2 of the WSBN Rules and Regulations was updated effective 12.17.2025.'\", \"url\": \"https://wsbn.wyo.gov/announcements\"}, {\"label\": \"Wyoming State Board of Nursing Rules, Chapter 2 — Licensure/Certification Requirements, effective 17 December 2025 (the Board publishes the Wyoming Administrative Rules export, reference 054.0002.2.12172025, from its Licensing, Education and home pages). Establishes the four CNA examination requirements and the five-attempts-in-two-years cap; the six endorsement requirements and the fallback to examination; the CNA II, MA-C and 16-hour Home Health Aide add-ons; the renewal cycle definition running 'from January 1st of every odd year to December 31st of every even year'; the October-1-of-even-year application date and 'Failure to receive a renewal notice from the Board does not excuse'; 'All licenses and certificates expire on December 31st of the renewal year'; the relicensure, inactive-status and reinstatement routes; and the three CNA continuing-competency options at § 14(e).\", \"url\": \"https://drive.google.com/file/d/1LgXrM7pK_pGxFz7gxhu_pUOtTIKKucNI/view\"}, {\"label\": \"Wyoming State Board of Nursing Rules, Chapter 5 — Fees, effective 26 May 2026 (Wyoming Administrative Rules export, reference 054.0002.5.05262026). Establishes every Board fee quoted on this page — CNA examination $60, endorsement $60, DCI background check $60, temporary permit $25, renewal $50, recertification $60, reactivation $50, inactive $30, verification $25, name change $20, pre-application determination $15, add-on certifications $5 — together with the nonrefundable rule, the wrong-license-type refund with its $25 processing charge, and the temporary provision suspending renewal fees from 1 October 2026 through 31 December 2026.\", \"url\": \"https://drive.google.com/file/d/1hddFhR9GIiPt3YXIicgrmE-QfA1ynWr_/view\"}, {\"label\": \"Wyoming State Board of Nursing Rules, Chapter 3 — Scope and Standards of Nursing Practice and CNA Role, effective 7 September 2017 (Wyoming Administrative Rules export, reference 054.0002.3.09072017). Establishes that a CNA is unlicensed assistive personnel for delegation purposes, that 'The CNA, regardless of title or care setting, shall be under the direction of an APRN, RN, or LPN', the six categories of the CNA role, and the delegation standards and delegatee responsibilities.\", \"url\": \"https://drive.google.com/open?id=1c-P1XnZ4KjE4QltPYNtZjXTMZkS1w6v5\"}, {\"label\": \"Wyoming State Board of Nursing — CNA Examination / Endorsement Checklist (board form dated 6/23/2025). Establishes the combined fee the Board quotes to applicants — 'Examination —Required Documents— Fee $120.00 (Add $25 if Temporary needed)' and the same for endorsement — and the document lists: application with payment, lawful presence (driver's license and social security card copies), certificate of course completion, two mailed fingerprint cards, and for endorsement the verification form from the original state plus proof of passing the competency examination.\", \"url\": \"https://drive.google.com/file/d/1cwJcRycm-ZaPuLIXLyOdsuIYX5sf8jVd/view\"}, {\"label\": \"Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys — CNAs. Establishes the Department's half of the credential: 'Wyoming CNA Registry – A registry of certified nurse aides (not individuals with temporary permits) who are fully certified by the Wyoming State Board of Nursing to provide services in certified nursing homes and swing beds'; the HLS/CNA-109 registry request form and the HLS/CNA-105 facility abuse-reporting form; the training-program application HLS/CNA-101 and the approved training programs list HLS/CNA-107 with its companion map; the Nursing Homes with Denial or Withdrawal of NATCEP list and Policy 23 on waivers; and the Department's own links to the WSBN verification portal and to Headmaster's Wyoming testing information.\", \"url\": \"https://health.wyo.gov/aging/hls/certified-nurse-aides/\"}, {\"label\": \"Wyoming Department of Health — Certified Nurse Aide Training Program application, form HLS/CNA-101 (Nov 2023). Establishes what the Department examines when approving a programme and, importantly, that it collects rather than prescribes the hours: items 23, 24 and 25 ask for 'Length of the course in hours', 'Number of hours of classroom instruction' and 'Number of hours of supervised practical training'. Also establishes the primary-instructor standard ('Verification of 2 years experience as an RN with 1 year in long term care' plus adult-teaching preparation), the one-year minimum experience for supplemental instructors, the requirement to show compliance with the prohibition on charging nurse aides employed by or holding an offer from a nursing home, and the categorical note 'Headmaster is the only approved facilitator in Wyoming.'\", \"url\": \"https://health.wyo.gov/wp-content/uploads/2023/11/101-CNA_Application.doc\"}, {\"label\": \"Wyoming Nurse Aide Candidate Handbook, Version 2, effective 1 October 2024, D&S Diversified Technologies LLP — Headmaster LLP (the handbook the Wyoming State Board of Nursing links from its Education page and the Department of Health links from its CNA page). Establishes the two-part examination and 'Candidates must pass both parts to be identified and listed on the Wyoming Nurse Aide Registry'; the definition and content of the Wyoming Nurse Aide Registry (WYNAR); the testing fee table (knowledge or knowledge retake $32.00, audio knowledge $42.00, skill test or skill retake $95.00); the 60-question, 60-minute knowledge exam with its subject-area distribution and the 76% pass mark; the audio and remotely proctored options; the skills test structure with one mandatory hand-washing task plus two or three random tasks, the manikin tasks, and the 80%-plus-all-key-steps rule; 'You have five (5) attempts within a two (2) year period following graduation'; the 120-day facility employment window for students; the endorsement eligibility conditions; and the $25 test review deposit.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/wyoming/forms/WY%20NA%20Candidate%20Handbook%20V2%208.2024.pdf\"}, {\"label\": \"D&S Diversified Technologies — Wyoming Nurse Aide (the vendor's Wyoming page, linked by the Board's Education page). Establishes 'D&SDT-Headmaster is honored to be approved by the Wyoming State Board of Nursing to offer Certified Nurse Aide Testing Services', the current candidate handbook version and effective date, and the candidate-facing forms — knowledge exam, remotely proctored knowledge exam and skill test instructions, the ADA accommodation form, the refund and test review request forms, and the Wyoming mock skills and recording forms.\", \"url\": \"https://www.hdmaster.com/testing/cnatesting/wyoming/WY_CNA_Home.htm\"}, {\"label\": \"Wyoming State Board of Nursing — Board of Nursing Certification Verification Portal (the 'Verify A CNA' lookup, linked from the Board's home and licensing pages and from the Department of Health's CNA page). Its own form establishes the search modes listed under Verify a license on this page — last and first name with a maiden-name option, license number, or NCSBN ID — and the credential-type list CNA, CNA II, Home Health Aid and MAC.\", \"url\": \"https://wybn.boardsofnursing.org/licenselookup\"}, {\"label\": \"Wyoming Statutes, Title 33 — Professions and Occupations, official full-title text published by the Wyoming Legislature as a single compressed PDF (816 pages; chapter 21, Nurses, begins at the internal heading 'CHAPTER 21 - NURSES'). Establishes every statutory quotation on this page: the 'Certificate' and 'Practice of a certified nursing assistant/nurse aide' definitions at 33-21-120(a)(v) and (a)(xii); the certification qualifications at 33-21-127; the reexamination-cap duty at 33-21-128(c); biennial renewal and forfeiture at 33-21-129; inactive status at 33-21-131; the ninety-day temporary permit and its one-time, nonrenewable limits at 33-21-132; the title-protection and unlawful-employment offences at 33-21-145(a)(iii) and (iv); the employer reporting duty at 33-21-153; and the exemptions at 33-21-154. Wyoming does not publish this chapter at a stable per-section address, so the whole-title PDF is the citable form.\", \"url\": \"https://www.wyoleg.gov/statutes/compress/title33.pdf\"}, {\"label\": \"42 CFR 483.152, eCFR. Establishes the federal minimums that apply where Wyoming states none: 'Consist of no less than 75 clock hours of training'; 'Include at least 16 hours of supervised practical training'; 'At least a total of 16 hours of training in the following areas prior to any direct contact with a resident'; and the no-charge rule at 483.152(c) that the Wyoming Department of Health's training-program application requires each program to satisfy.\", \"url\": \"https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-D/section-483.152\"}]",
   "page_url": "https://licensingatlas.com/cna/wy-cna/"
  }
 ]
}