Nursing Assistant Training Requirements by State
|State||Minimum Training Hours||Minimum Clinical Hours|
|District of Columbia||120||75|
Federal legislation (the 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 states. 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.
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.
In its report on the adequacy of the healthcare workforce for older Americans (Retooling for an Aging America, 2008) the National Academy of Medicine (formerly 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).
- Over half of states have chosen to require more than the minimum federal standard of 75 hours for nursing assistant training.
- 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, the standard recommended by the National Academy of Medicine report.
- 32 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.
- Even though many states have gone beyond the minimum federal requirements, 20 states still operate with requirements that have not changed in over 20 years.
Alabama: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 483.
Alaska: Alaska Administrative Code, Title 12, 44.835.
Arizona: Arizona Administrative Code, Title 4, Chapter 19, Article 8.
Arkansas: Arkansas Administrative Code 20‐10‐701.
California: California Code of Regulations, Title 22, Division 5, Chapter 2.5, Article 3.
Colorado: Code of Colorado Regulations, 3 CCR 717‐1, Chapter XI.
Connecticut: Connecticut Department of Public Health Regulations, Public Health Code, Chapter IV, Title 19‐13‐D8t.
Delaware: Delaware Code, Title 16, Chapter 30A.
District of Columbia: District of Columbia Municipal Regulations, Title 29, Chapter 32, Nurse Aide Certification, Section 3204.
Florida: Florida Administrative Code, Rule Chapter: 64B9‐15.
Georgia: Alliant GMCF, Nurse Aide Program Overview.
Hawaii: Hawaii Administrative Rules, Title 16, Chapter 89A, and Med‐QUEST Division, Certification Programs, “State Certified Nurse Aide Training Program” (May 2004).
Idaho: Health Professions Program, Idaho Division of Professional‐Technical Education, “How to Start a Nursing Assistant Course.”
Illinois: Illinois Administrative Code, Title 77, Chapter I, Subchapter c: Long‐Term Care Facilities, Section 395.150.
Indiana: Indiana Administrative Code, 410 IAC 16.2‐3.1‐14.
Iowa: Iowa Administrative Code 441.81.16
Kansas: Kansas Administrative Regulations 28‐39‐165.
Kentucky: Kentucky Administrative Regulations, Title 907, Chapter 1, Section 450. Louisiana: Louisiana Administrative Code, Title 48: I. 10001‐10079.
Maine: Code of Maine Rules, 02‐380, Chapter 5.
Maryland: Code of Maryland Regulations, Title 10.39.02.07.
Massachusetts: Code of Massachusetts Regulations, Title 105.156.320.
Michigan: Michigan Department of Community Health, Bureau of Health Professions, Nurse Aide Training Curriculum.
Minnesota: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 483.
Mississippi: Follows Federal Code of Regulations: CFR Title 42, Vol. 3, 483.
Missouri: Missouri Code of State Regulations, Title 19, 30‐84.010.
Montana: Montana Department of Public Health and Human Services, Quality Assurance Division, Certification Bureau, State Plan for the Nurse Aide Training and Competency Testing Program.
Nebraska: Nebraska Administrative Code, Title 172, 108‐003.01 (172 NAC 108‐003.01).
Nevada: Nevada Revised Statues, Chapter 632 – Nursing, NRS 632.2856.
New Hampshire: New Hampshire Code of Administrative Rules, Chapter Nur 10, Section Nur 704.09.
New Jersey: New Jersey Administrative Code, 8:39‐43.10.
New Mexico: New Mexico Administrative Code, 8.312.2.21.
New York: New York Codes, Rules and Regulations (NYCRR), Title 10, Section 415.26.
North Carolina: North Carolina Department of Health and Human Services, Division of Health Service Regulation, Center for Aide Regulation and Education, State Approved Curriculum for Nurse Aide I Training.
North Dakota: North Dakota Administrative Code, 33.07.06.02.
Ohio: Ohio Revised Code, Title 37, 3721.30.
Oklahoma: Oklahoma Administrative Code, Title 310, 677‐11‐4.
Oregon: Oregon Administrative Code, 851‐061‐0090.
Pennsylvania: Pennsylvania Department of Education, Application for Approval of Nurse Aide Training and Competency Evaluation Program, June 2012
South Carolina: South Carolina Department of Health and Human Services, Department of Facility Services, South Carolina Nurse Aide Training Program Packet, “Guidelines for Nurse Aide Program Training Approval.”
South Dakota: South Dakota Administrative A1:G52 44:74:02:15.
Tennessee: Tennessee Annotated Code 68-11-209
Texas: Texas Administrative Code, Title 40, Part 1, Rule 94.3.
Utah: Utah Administrative Code, Rule R432-45.
Vermont: Vermont Board of Nursing, Administrative Rules, Part 16.12.
Virginia: Virginia Administrative Code, 18VAC90-26-50
Washington: Washington Administrative Code, Chapter 246‐841‐490.
West Virginia: West Virginia Department of Health and Human Resources, Bureau for Public Health, Office of Health Facility Licensure and Certification, Nurse Aide Educational Program, Criteria and Guidelines.
Wisconsin: Wisconsin Administrative Rules and Regulations, Chapter HFS 129, Certification of Programs for Training and Testing Nurse Aides, Medication Aides and Feeding Assistants, Subchapter II.
Wyoming: Wyoming State Board of Nursing, Administrative Rules and Regulations, Ch. II, Section 5(b).