Certified Nursing Assistants (CNAs) provide direct patient care, and maintaining an active certification is required by law. In North Carolina, the status of a Nurse Aide I is tracked by the N.C. Nurse Aide Registry, which is managed by the Division of Health Service Regulation (DHSR). Understanding the specific rules set by the DHSR is the first step toward regaining an active listing.
Understanding NC CNA Listing Status
A CNA’s listing status in North Carolina is determined by recent work history. A listing is “Active” if the individual has verified employment performing paid nursing services within the preceding 24 months. These services must total a minimum of eight hours of work supervised by a Registered Nurse (RN).
If the required eight hours of paid, supervised nursing work are not documented and verified within the 24-month timeframe, the listing automatically transitions to an “Expired” status. This means the individual is no longer authorized to work as a Nurse Aide I in the state. Regaining eligibility requires a more extensive process.
Immediate Steps When Your Listing is Expired
The first step upon realizing your CNA listing may be expired is to verify your status and the exact expiration date through the official N.C. Nurse Aide Registry lookup tool on the DHSR website.
If the listing expired due to a failure to meet the 24-month work requirement, the only way to return to active status is to re-qualify. This re-qualification requires successfully passing the state-approved Nurse Aide Competency Evaluation Program. The registry does not allow for the submission of late work verification once the deadline has passed.
Re-qualifying Through the Competency Examination
Re-qualification for a Nurse Aide I with an expired listing requires completing a new, state-approved Nurse Aide I training program. The North Carolina DHSR mandates this full retraining and retesting when the required work hours were not met. This comprehensive approach ensures that individuals returning to the field have current knowledge and skills that meet state standards.
The first administrative step is enrolling in a state-approved Nurse Aide I program, which must consist of a minimum of 75 hours of instruction. Once training is complete, the provider will submit the necessary documentation to the testing vendor, Credentia.
You must also ensure that your eligibility is not precluded by any substantiated findings of abuse, neglect, or misappropriation of property, as such findings result in permanent disqualification from the registry. After the training provider confirms your eligibility, you will register with the testing vendor, Credentia, through their CNA365 system. This online platform is where you will manage your application and eventually schedule the required competency examination.
The Competency Examination Process and Requirements
The re-qualification exam is the National Nurse Aide Assessment Program (NNAAP), administered by Credentia in North Carolina. This evaluation is composed of two distinct components that must both be successfully passed: the Written or Oral Examination and the Skills Demonstration Exam. Both parts are typically scheduled and taken on the same day.
The Written Examination consists of 70 multiple-choice questions, which candidates must complete within a two-hour time limit. An Oral Examination option is available for candidates who prefer this format, which generally consists of 60 multiple-choice questions and 10 reading comprehension questions.
The Skills Demonstration Exam requires the candidate to perform five randomly selected nurse aide tasks in front of an evaluator. To pass the skills portion, you must correctly perform four of the five assigned tasks, including all procedural steps designated as critical.
Candidates are allowed a total of three attempts to successfully pass both the Written/Oral and Skills Demonstration exams. If a candidate fails either part three times, they are required to repeat a full, state-approved Nurse Aide I training program before attempting the exam again. Comprehensive preparation materials are available through the Credentia website.
Administrative Fees and Official Resources
The re-qualification process involves administrative costs related to the competency examination. The initial fee for taking both the Written Examination and the Skills Evaluation together is typically $140.
If a candidate needs to re-test on a single component, the fee is $40 for the Written or Oral Examination only, and $100 for the Skills Evaluation only. Examination fees are non-refundable and non-transferable, and they must be paid at the time of registration through the CNA365 system.
Under federal law, if you are employed by, or have a written commitment from, a Medicare or Medicaid-certified nursing home, that facility is required to pay for the examination and any necessary re-test fees. Candidates must use official sources for all current fee schedules and application forms, which include the N.C. DHSR Nurse Aide Registry and the Credentia website.
Ensuring Future Listing Maintenance
Once the competency examination is passed and the listing is active, focus must shift to future maintenance. The requirement remains the verification of at least eight hours of paid nursing services, supervised by an RN, within every 24-month period. Proactive documentation prevents future expiration.
The renewal process involves two online steps: the Nurse Aide I submits the online renewal form, and a Registered Nurse submits the online Employment Verification Form. This dual submission confirms the work was performed and supervised according to state standards. Timely submission is necessary before the current listing expiration date, and you should update any change of address or name directly with the Registry.