A Certified Nursing Assistant (CNA) does not hold a compact license; this distinction is a frequent point of confusion for healthcare professionals seeking to work across state lines. A CNA is a Certified Nursing Assistant, a role that provides direct patient care under the supervision of a licensed nurse. The term “compact license” refers to a multi-state authorization allowing certain licensed healthcare workers to practice in all member states with a single credential. CNAs, who hold a certification or registration rather than a full license, are not included in the Nurse Licensure Compact (NLC), the primary interstate agreement for nursing mobility.
The Foundation: Why CNA Certification Differs from Nursing Licensure
The regulatory structure for CNAs differs fundamentally from that of Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). CNA certification is managed at the state level, typically by the state’s board of nursing or a department of health. This state-centric control prevents a single, national standard for the CNA credential, making an interstate compact difficult to implement.
The Omnibus Budget Reconciliation Act of 1987 (OBRA 87) established a federal mandate for minimum training standards for nurse aides working in facilities receiving Medicare or Medicaid funding. This federal law requires a minimum of 75 hours of instruction, including at least 16 hours of supervised practical training. States can increase these minimum training hours, contributing to variations in certification requirements across the country. CNAs are placed on a state-specific Nurse Aide Registry, a public database that tracks their employment and any findings of patient abuse or neglect.
Understanding the Nurse Licensure Compact
The Nurse Licensure Compact (NLC) is an agreement that allows RNs and LPNs to practice in any NLC member state using a single, multi-state license issued by their home state’s board of nursing. The purpose of the NLC is to increase access to care and reduce the administrative burden of obtaining multiple single-state licenses for mobile nurses, such as travel nurses or those who live near state borders.
The NLC’s scope is strictly limited to licensed nurses, formally excluding Certified Nursing Assistants. This exclusion stems from the difference between state-level certification and professional licensure. Licensure involves a higher, more standardized level of education and scope of practice, which is easier to align across states than the varying certification requirements for nurse aides. Therefore, CNAs must follow a separate, state-by-state process to move their credentials.
Moving Between States: CNA Reciprocity and Endorsement
When a Certified Nursing Assistant moves to a new state, they must apply for the transfer of their credentials through a process called reciprocity or endorsement. This process is not automatic and requires the CNA to meet the receiving state’s specific requirements before being placed on the new state’s Nurse Aide Registry.
The primary requirement is that the CNA must be listed in “good standing” on their original state’s registry, meaning they have no substantiated findings of abuse, neglect, or misappropriation of patient property. Most states also require proof of recent, paid work experience to demonstrate current competency, often requiring a minimum number of hours worked within the preceding 24 months.
The CNA must submit a formal application, pay a fee that varies by state, and often undergo a new state and federal fingerprint-based criminal background check. The requirements for reciprocity can differ significantly. Some states offer true reciprocity, accepting the original certification without further testing. Others may require the CNA to complete additional state-specific training or retake the state’s competency exam. For instance, a state with higher training hour requirements may not grant full reciprocity to a CNA from a state with fewer mandated hours, necessitating further education or a skills evaluation.
Future Outlook for CNA Interstate Mobility
Advocacy efforts in the healthcare workforce are increasingly focused on improving mobility for all providers, including Certified Nursing Assistants. The difficulties CNAs face when moving between states highlight the need for greater standardization of training hours and scope of practice across the country. The current state-by-state system of reciprocity places a significant administrative burden on CNAs and can delay their entry into the workforce, which exacerbates staffing shortages in long-term care facilities.
While there are ongoing discussions about the benefits of a more uniform system, a formal CNA compact similar to the NLC is not currently on the immediate horizon. The political and logistical challenges of aligning the diverse state-level certification standards, which include varying minimum training requirements and differing regulatory bodies, remain substantial barriers. Any future solution will likely involve greater collaboration between state boards to harmonize requirements, simplifying the endorsement process and allowing CNAs to practice more quickly upon relocation.