The Certified Nursing Assistant (CNA) provides direct patient care under the supervision of licensed nursing staff. CNAs are primarily employed in long-term care facilities, hospitals, and home health settings, assisting patients with activities of daily living. Because healthcare professionals are regulated at the state level, a CNA certification does not automatically transfer when a professional moves. Moving a certification requires the CNA to be accepted by the new state, usually through a mechanism known as reciprocity.
Understanding CNA Certification and State Regulation
The need for a transfer process stems from the jurisdictional control states maintain over professional certification. Although the federal Omnibus Budget Reconciliation Act of 1987 (OBRA) established minimum requirements for nurse aide training and competency, each state retains the authority to implement and enforce these standards. OBRA mandates that states require at least 75 hours of training and maintain a central Nurse Aide Registry (NAR).
This regulatory structure means that the curriculum, training hours, testing, and renewal requirements vary significantly between states. The state’s Nurse Aide Registry, often overseen by the Board of Nursing, tracks certified individuals and their good standing. When a CNA moves, the receiving state must confirm that the original training and certification meet its established standards for patient safety.
The Primary Method: Reciprocity and Endorsement
The standard pathway for a certified CNA to practice in a new state is through reciprocity, sometimes called endorsement. Reciprocity is a mutual agreement where one state recognizes and accepts the training and certification granted by another state. This acceptance allows the CNA to bypass repeating the full training course and re-taking the state competency examination.
Endorsement describes the act of the receiving state officially accepting the out-of-state certification and placing the CNA’s name on its own registry. This process is founded on the principle that the original certification met the federal minimum standards established by OBRA. A successful endorsement results in the CNA being officially listed on the new state’s registry, which is required for legal employment in that jurisdiction.
Essential Eligibility Requirements for Transfer
Before initiating paperwork, a CNA must confirm they meet several criteria to be eligible for reciprocity. The most fundamental requirement is that the existing certification must be active and in good standing with the original state’s registry. Certifications that have lapsed or expired are disqualified from the streamlined reciprocity process.
A second requirement is that the applicant must not have any documented findings of patient abuse, neglect, or misappropriation of resident property on any state registry. This information is maintained on a Disqualifying Registry, and such a finding prevents certification in a new state.
Most states also have a recent work requirement. The CNA must have worked a minimum number of hours, often 8, 40, or 75 hours, performing nursing-related duties for pay within the last 24 months to prove current competency. Finally, the receiving state mandates a state and federal criminal background check, often requiring electronic fingerprinting, to ensure patient safety standards are met.
Steps for Transferring Your CNA Certification
The first step is to contact the Nurse Aide Registry or the Board of Nursing in the state where you intend to work. This regulatory body provides the official application for reciprocity, which can often be completed online. Review the checklist of required documentation, which typically includes a government-issued photo ID and proof of social security number.
Once the application is complete, pay all required processing fees, which vary between states. A crucial step involves requesting verification of your good standing from the original state’s registry. The new state requires this official documentation to confirm your active status and absence of any disqualifying findings.
After gathering all materials, including proof of work hours if required, the complete application package is submitted for review. Once approved, the CNA’s name is placed on the new state’s Nurse Aide Registry, completing the transfer and allowing the individual to legally begin working.
When Reciprocity Is Not Possible
A CNA may be denied reciprocity due to an expired certification, a prolonged lapse in practice, or substantial differences in training requirements between states. If a certification has been inactive for more than the mandatory period, often 24 consecutive months without paid work, the CNA is ineligible for reciprocity.
When the primary transfer path is unavailable, the applicant must pursue an alternative route. The most common alternative is to challenge the state-specific CNA competency exam, passing both the written and skills portions without repeating the full training course.
If the certification has been expired for an extended period, the applicant may be required to complete a new state-approved CNA training program entirely. Some states offer temporary work permits while a reciprocity application is pending, but these are not guaranteed and are not a substitute for full certification.
Maintaining Your Certification in the New State
Once listed on the new state’s registry, the CNA must adhere to that jurisdiction’s ongoing requirements to keep the certification active. Renewal cycles vary, with many states requiring renewal every two years. The CNA must track this renewal date diligently to avoid a lapse in active status.
A standard requirement for renewal is the completion of Continuing Education Units (CEUs) or in-service training hours. Many states mandate approximately 12 hours of CEUs per year, totaling 24 hours over a biennial renewal period.
The CNA must also meet the new state’s minimum paid work hour requirement, which ranges from 8 to 75 hours within the preceding 24 months, to qualify for subsequent renewals and maintain the right to practice.