Download: State Nurse Aide Training Requirements, 2009 (pdf)
Background
Federal legislation (Omnibus Budget Reconciliation Act of 1987) and associated regulations (42 CFR 483.152) require that Medicare- and Medicaid-certified nursing homes employ nurse aides who are trained and evaluated through training programs approved by their state. Federal regulations require that these training programs consist of at least 75 hours of training, including at least 16 hours of supervised practical or clinical training.
Related Resources
Federal regulations also list the subject areas and skills to be taught, outline the qualifications for approved trainers, define the competency evaluation process, and require that each state establish and maintain a registry of nurse aides.
PHI Findings
Just over half of states have chosen to require additional hours of classroom and clinical training, as summarized in the accompanying chart:
- 30 states and the District of Columbia have extended the minimum number of training hours beyond 75 hours to as many as 180 hours.
- 13 states and the District of Columbia require a minimum of 120 or more training hours.
- 33 states and the District of Columbia require more than the minimum 16 hours of clinical training, with required clinical hours ranging up to 100 hours.
Despite the fact that many states have gone beyond the minimum federal requirements, 20 states still operate with requirements that have not changed in over twenty years.
In its recent report on the adequacy of the healthcare workforce for older Americans (Retooling for an Aging America, 2008), the Institute of Medicine recommends that “Federal requirements for the minimum training of certified nursing assistants (CNAs) and home health aides should be raised to at least 120 hours and should include demonstration of competence in the care of older adults as a criterion for certification” (Recommendation 5-1).
