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					                                                                                               Summary of State CNA Training Regulations




                              Federal Regulations                  Alabama                     Alaska                         Arizona                         Arkansas                             California                 Colorado                     Connecticut                        Delaware




Type of facility covered   SNF                            SNF                       SNF/AL                           SNF                            SNF                                SNF/ICF                       SNF                           SNF                              SNF/ICF/AL
Regulatory governing       OBRA 87--Code of Federal       Alabama Dept. of Public   Alaska State Board of Nursing; Arizona State Board of           Arkansas Dept of Human         California Dept of Health Services Curriculum must be State     State approved--Connecticut Dept. of Health and Social
body/law                   Regulations 42, Part 483       Health                    program must be established Nursing                             Services; Division of Economic                                    approved--Colorado State     Department of Health Services Services on recommendation
                                                                                    through an approved                                             and Medical Services; Office                                      Board of Nursing.                                          of the CNA Training Curriculum
                                                                                    postsecondary educational                                       of LTC                                                                                                                       Committee
                                                                                    institution.

Authorized training                                                                                                                                 LTC facility; community
providers                                                                                                                                           college; Vo-Tech school;
                                                                                                                                                    proprietary school; clinical
                                                                                                                                                    training must be in LTC facility




Training program           No fewer than 75 clock hours                             80 hours; at least 32 of these   120 hours of classroom and     Minimum of 75 hours training       150 hours                     Minimum of 75 hours of        100 hours --must include         Minimum of 150 hours, divided
requirements               of training.                                             must be supervised practical     clinical instruction.          with a balance between                                           instruction. Training must    training in understanding and    equally between clinical skills
                                                                                    training.                                                       theory instruction and skills                                    address the nursing,          responding to physical,          training and classroom
                                                                                                                                                    training.                                                        psychosocial, physical and    psychiatric, psycholsocial and   instruction. Additional hours
                                                                                                                                                                                                                     environmental needs equally   cognitive disorders.             may be in either or both of
                                                                                                                                                                                                                     with the medical needs.                                        these areas.




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                                                                                                         Summary of State CNA Training Regulations

                              Federal Regulations                     Alabama                           Alaska                              Arizona                            Arkansas                              California                    Colorado                   Connecticut             Delaware
Minimum hours of         Must include at least 16 hours                                      60 hours classroom minimum         80 hours classroom minimum;        Part I--16 hours classroom          50 hours classroom; 100 hours of 16 hours minimum preclinical
classroom and clinical   of supervised practical training                                                                       40 hours clinical instruction in   minimum (includes both theory       clinical training conducted       classroom/nursing skills
instruction              (training in a laboratory or                                                                           a facility-based program           and skills demonstration in         between hours of 6:00am and       practice area instruction.
                         other setting in which the                                                                             completed within the last 24       classroom lab).                     8:00pm. Must take place in a
                         trainee demonstrates                                                                                   calendar months prior to           Part II--required completion of     nursing facility and conducted in
                         knowledge while performing                                                                             exam.                              the remaining 59 hours of           conjunction with classroom
                         tasks on an individual under                                                                                                              training consisting of theory,      instruction.
                         the direct supervision of a                                                                                                               classroom lab and clinical skills
                         registered nurse or a licensed                                                                                                            training; at least 16 hours of
                         practical nurse).                                                                                                                         supervised practical training in
                                                                                                                                                                   a facility.




In-service training      Performance evaluation              At least 12 hours per year      Certification must be renewed                                         1 hour of in-service training        24 hours of in-service training or   In-service education is                        Must complete at least 64
required                 required at least once every        based on outcome of annual      biennially with at least 160                                          required per month to address       continuing education required per     required based on outcome of                   hours of nursing related
                         12 months with regular in-          performance review.             monetary compensation hours                                           areas of weakness as                year to renew certification. Shall    performance review which                       services in a health care
                         service education based on          Address areas of                completed within two years                                            identified in annual                include multiple topics in a state    must be completed every 12                     setting during each 24-month
                         the outcome of reviews.             weaknesses as determined        preceding the date of                                                 performance review and to           approved program.                     months. Must be sufficient to                  certification period to quality
                         -Must be sufficient to ensure       by performance review and       application. Must complete 24                                         address the special needs of        -1 hour of classroom theory           ensure the continuing                          for recertification. Otherwise,
                         continuing competence of            special needs of residents as   contact hours during the                                              residents as determined by          accepted as 1 CEU hour;               competence of the nurse aide                   training course and
                         nurse aides, but no less than       determined by the facility      concluding certification period.                                      each facility                       -3 hours in a course related          and no less than 12 hours per                  competency exam must be
                         12 hours per year.                  staff. Must include services                                                                                                              clinical training accepted as 1 CEU   year. Must include care of the                 repeated.
                         -Must address areas of              to cognitively impaired for                                                                                                               hour.                                 cognitively impaired for aides
                         weakness as determined by           aides who provide those                                                                                                                                                         providing those services.
                         performance evaluation and          services.                                                                                                                                 Annual performance review
                         may address special needs of                                                                                                                                                  required with regular in-service
                         residents as determined by                                                                                                                                                    training based on the outcome of
                         facility staff.                                                                                                                                                               these reviews. Content of
                         -Must address care of the                                                                                                                                                     training program shall enhance
                         cognitively impaired for nurse                                                                                                                                                knowledge and skills learned in
                         aides providing those                                                                                                                                                         the certification program and
                         services.                    Must                                                                                                                                             address areas of weakness,
                         include at least 16 hours of                                                                                                                                                  special needs of patients,
                         supervised practical training                                                                                                                                                 including those with cognitive
                         (training in a laboratory or                                                                                                                                                  needs, and areas of facility
                         other setting in which the                                                                                                                                                    deficiencies following the last
                         trainee demonstrates                                                                                                                                                          licensing survey.
                         knowledge while performing
                         tasks on an individual under
                         the direct supervision of a
                         registered nurse or a licensed
                         practical nurse).




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                                                                                             Summary of State CNA Training Regulations


                                  Federal Regulations                   Alabama              Alaska                      Arizona                         Arkansas                           California                          Colorado                  Connecticut              Delaware
Competency exam                                                                   Written Examination          Written and manual skills     Includes manual skills and      Required                                 Written and manual skills   Required              Required
                                                                                                               exam.                         candidate's choice of written                                            evaluation.
                                                                                                                                             or oral exam. Oral exam read
                                                                                                                                             from prepared text. Exam must
                                                                                                                                             be completed within 12 months
                                                                                                                                             of graduation from a training
                                                                                                                                             program. Exam is offered in
                                                                                                                                             English only. Skills
                                                                                                                                             demonstration is 5 randomly
                                                                                                                                             selected items drawn from a
                                                                                                                                             pool of tasks ranked according
                                                                                                                                             to difficulty. A fee is charged
                                                                                                                                             for the state competency
                                                                                                                                             evaluation, but the fee is paid
                                                                                                                                             by the state for those
                                                                                                                                             employed or who have a letter
                                                                                                                                             of intent from a LTC facility.

Number of attempts            No less than 3 times.                                                                                          3 times                            3 times
allowed to pass exam
before training must be
repeated
Other requirements            May not charge fees for                             Must successfully complete                                 Facilities may use student         Health evaluation is required prior                                                     CNAs may pursue designation
                              training or textbooks if nurse                      the CNA Competency                                         trainees in staffing while in      to participation in segments of                                                         as a Senior CNA with a
                              aide is employed by or has                          Evaluation -National Nurse                                 training following completion of   training program which required                                                         minimum of 3 years
                              received an offer of                                Aide Assessment Program                                    Part I, a minimum of 10 hours      contact with patients.                                                                  employment and completion of
                              employment from a LTC facility                      (NNAAP).                                                   per week must be spent in                                                                                                  an additional 50 hours of
                              on the date training began; if                                                                                 training until the program is                                                                                              advanced training in a state
                              the aide receives an offer of                                                                                  completed.                                                                                                                 approved program, and
                              employment no later than 12                                                                                                                                                                                                               passed a competecy test.
                              months after completing                                                                                                                                                                                                                   Curriculum must include
                              training, state pays for training                                                                                                                                                                                                         leadership training and
                              on pro rata basis                                                                                                                                                                                                                         mentoring skills, dementia
                                                                                                                                                                                                                                                                        training, and advanced
                                                                                                                                                                                                                                                                        geriatric nursing assistant
                                                                                                                                                                                                                                                                        training.
Maximum period                May not use an individual more 4 months                                          Must submit application within 4 months                          4 months                                                          120 days              Any individual who has
individual may work in a      than 4 months on a full-time                                                     30 days of hire and employed                                                                                                                             completed all of the classroom
facility before meeting       basis unless that individual                                                     by same facility for 75-100                                                                                                                              training and half of the clinical
training qualifications and   has completed a training and                                                     days.                                                                                                                                                    training in a facility sponsored
certification                 competency evaluation                                                                                                                                                                                                                     training program may be
                              program approved by their                                                                                                                                                                                                                 considered as a member of
                              state. (Part time, per diem, etc.                                                                                                                                                                                                         such facility's staff while
                              employees must meet the                                                                                                                                                                                                                   undergoing the last 37.5 hours
                              same requirements.)                                                                                                                                                                                                                       of clinical training at such
                                                                                                                                                                                                                                                                        facility.




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                                                                                                   Summary of State CNA Training Regulations
                                Federal Regulations                     Alabama                  Alaska                           Arizona                          Arkansas                           California                          Colorado                     Connecticut                     Delaware
Course curriculum                                                                      As approved by the State        Standardized curriculum           Training courses must be                                                                               Nurse Assistant Training
specified                                                                              Board of Nursing.               providing a basic level of both   prepared and administered in                                                                           Program through the State
                                                                                                                       knowledge and demonstrable        accordance with the training                                                                           Department of Education or
                                                                                                                       skills.                           course guildelines prescribed                                                                          Connecticut Regional
                                                                                                                                                         in the Arkansas LTCF Nursing                                                                           Community College system.
                                                                                                                                                         Assistant Training Curriculum.
                                                                                                                                                         The Dept. will not require or
                                                                                                                                                         endorse any one textbook or
                                                                                                                                                         other material.




Training required prior to   16 hours in communication and                             Orientation which includes 16   16 hours                          16 hours; can only be            At least 16 hours of training in the                                                               Classroom instruction and
providing direct care to a   interpersonal skills; infection                           hours classroom training and                                      assigned duties for which        following areas:                                                                                   demonstrated proficiency in
resident                     control; safety and emergency                             16 hours of specific skills                                       they have demonstrated           -Communication and interpersonal                                                                   each skill shall be completed
                             procedures, including the                                 training.                                                         competency                       skills;                                                                                            prior to students performing
                             Heimlich maneuver; promoting                                                                                                                                 -Infection control;                                                                                direct resident care.
                             residents' independence;                                                                                                                                     -Safety and emergency                                                                              Any individual who has
                             respecting residents' rights;                                                                                                                                procedures, Heimlich maneuver;                                                                     completed all of the classroom
                             basic nursing skills; personal                                                                                                                               -Promoting independence of                                                                         training and half of the clinical
                             care skills; mental health and                                                                                                                               patient;                                                                                           training in a facility sponsored
                             social services of residents;                                                                                                                                -Respecting the right's of the                                                                     training program may be
                             care of cognitively impaired                                                                                                                                 patient.                                                                                           considered as a member of
                             residents; basic restorative                                                                                                                                                                                                                                    such facility's staff while
                             services; and residents' rights                                                                                                                                                                                                                                 undergoing the last 37.5 hours
                                                                                                                                                                                                                                                                                             of clinical training at such
                                                                                                                                                                                                                                                                                             facility.




Maximum time allowed          24 consecutive months            24 consecutive months                                                                     24 consecutive months --must Must renew certification every 2                                          24 consecutive months
before training program                                                                                                                                  document having worked at     years.
and competency exam                                                                                                                                      least one day (8 hours). Must
must be repeated for                                                                                                                                     be recertified every 2 years.
recertification if individual
has not provided nursing
or nursing-related
services for monetary
compensation

Deadlines to complete the                                                              Within 5 years immediately                                                                                                                Exam must be passed within 2                                Test must be taken within 30
training course and exam                                                               before date of application.                                                                                                               years of receipt of the                                     days completion of training or
                                                                                                                                                                                                                                 certification application.                                  when the nearest testing
                                                                                                                                                                                                                                                                                             location is available,
                                                                                                                                                                                                                                                                                             whichever is later.
                                                                                                                                                                                                                                                                                             Test may be taken 2 additional
                                                                                                                                                                                                                                                                                             times, but must be passed
                                                                                                                                                                                                                                                                                             within 90 days of training or
                                                                                                                                                                                                                                                                                             training must be repeated.




                                                                                                                                                     9/29/2013                                                                                                                                                 Page 4 of 69
                                              Summary of State CNA Training Regulations




              Federal Regulations   Alabama   Alaska      Arizona               Arkansas                             California                           Colorado                Connecticut              Delaware
Orientation                                                           Provides the nursing assistant    An approved Orientation (at least     Instruction must provide an                       Minimum of 80 hours, at least
                                                                      with explantions of facility      16 hours) must be given to all non-   orientation of trainees to the                    40 of which must be clinical.
                                                                      structure, policies,              certified nurse assistants during     clinical facility to include an                   Exception: Any nursing
                                                                      procedures, philosophy of         the first 40 hours of employment.     explanation of the                                assistant who has undergone
                                                                      care, description of resident     Must include:                         organizational structure of the                   150 hours of training where
                                                                      population and employee rules.    -Tour of the facility, description of facility, policies and                            the individual will be employed
                                                                      Not included as part of the       patient population, use of            procedures, philosophy of                         by the facility thereafter, shall
                                                                      Nursing Assistant Training        equipment and daily routine;          care of the facility, description                 only complete additional facility
                                                                      program; not included in the 75   -Emergency procedures;                of the resident population and                    specific orientation of 40
                                                                      hours of training                 -Introduction to patient care;        employee rules. This                              hours in the same facility.
                                                                                                                                              orientation is not included in                    During orientation, direct
                                                                                                        The first 8 hours of this orientation the 75 hours required in the                      contact with residents may be
                                                                                                        must be conducted prior to            basic curriculum.                                 made only with visual
                                                                                                        providing direct patient care. The                                                      supervision.
                                                                                                        remaining 8 hours must be                                                               CNAs employed by temporary
                                                                                                        presented within the next 32                                                            agencies and placed in a
                                                                                                        hours of employment.                                                                    facility where they have not
                                                                                                                                                                                                worked within the previous 6
                                                                                                        The orientation and certification                                                       months shall undergo a
                                                                                                        program shall not be claimed by                                                         minimum of 2 hours of
                                                                                                        the CNA as in-service or                                                                orientation prior to their first
                                                                                                        continuing education credit.                                                            shift--they will not be
                                                                                                                                                                                                considered a facility employee
                                                                                                                                                                                                for purpose of satisfying
                                                                                                                                                                                                minimum facility staffing
                                                                                                                                                                                                requirements.




                                                                    9/29/2013                                                                                                                                     Page 5 of 69
                                                                                               Summary of State CNA Training Regulations




                               District of Columbia                 Florida                     Georgia                      Hawaii                        Idaho                          Illinois                        Indiana                          Iowa                            Kansas




Type of facility covered   SNF                            SNF                          SNF                        SNF                           SNF                           SNF                              SNF                             SNF                              SNF
Regulatory governing       follows OBRA 87--Code of       Florida Board of Nursing. All Georgia Medical Care      Training program approved by follows OBRA 87--Code of       Illinois Dept of Public Health   Indiana State Dept. of Health   Iowa Dept of Inspections and     Dept. of Education
body/law                   Federal Regulations 42, Part   programs must be licensed by Foundation                 Hawaii Dept. of Human        Federal Regulations 42, Part   Office of Health Care                                            Appeals (DIA)
                           483                            the Dept. of Education.                                 Services; admin. rules from  483                            Regulation Education and
                                                                                                                  Dept. of Commerce and                                       Training, Springfield, IL
                                                                                                                  Consumer Affairs

Authorized training                                                                    ProCare; American Red                                                                                                                                                                    community college, area
providers                                                                              Cross; State Vocational/                                                                                                                                                                 technical school, proprietary
                                                                                       Technical Curriculum;                                                                                                                                                                    school--accredited by Dept. of
                                                                                       (others must fill out                                                                                                                                                                    Education; adult care home;
                                                                                       application detailing                                                                                                                                                                    school under state board of
                                                                                       curriculum)                                                                                                                                                                              regents; LTC hospital unit

Training program           No fewer than 75 clock hours                                85 total hours required--  No fewer than 75 clock hours No fewer than 75 clock hours 120 hours of instruction         105 hours                         75 hours of training:            90 hours; must successfully
requirements               of training.                                                16 hours basic knowledge of training.                   of training.                 excluding orientation to the                                       to include 15 hours laboratory   complete part I of the course
                                                                                       (communication and                                                                   employing facility. Presented                                      experience;                      to demonstrate initial
                                                                                       interpersonal skills;                                                                in a minimum of 3 weeks and                                        30 hours classroom               competency prior to being
                                                                                       infection control; safety                                                            not exceeding 120 days,                                            instruction;                     employed or used as a nurse
                                                                                       and emergency                                                                        unless conducted by an                                             30 hours supervised clinical     aide trainee II (only nurse aide
                                                                                       procedures; promoting                                                                educational institution on a                                       training                         trainee II can provide direct
                                                                                       residents' independence;                                                             term, semester, or trimester                                                                        individual care to residents,
                                                                                       respecting residents'                                                                basis. There shall be a ratio of                                                                    under the direct supervision of
                                                                                       rights); part II: Basic                                                              2 hrs of theory, including                                                                          an RN or LPN)
                                                                                       Nursing Skills; Part III:                                                            supervised laboratory, to each
                                                                                       Personal Care Skills; Part                                                           hour of clinical instruction.
                                                                                       IV: Mental Health and                                                                Must include a minimum of 12
                                                                                       Social Service Needs; Part                                                           hours of theory instruction to
                                                                                       V: Restorative Nursing;                                                              Alzheimers disease and
                                                                                       Part VI: Patients' Rights;                                                           related dementias.
                                                                                       Part VII: Care of the
                                                                                       Cognitively Impaired
                                                                                       Resident




                                                                                                                                             9/29/2013                                                                                                                                               Page 6 of 69
                                                                                               Summary of State CNA Training Regulations

                              District of Columbia                      Florida                Georgia                 Hawaii                             Idaho                            Illinois                        Indiana                            Iowa                             Kansas
Minimum hours of         Must include at least 16 hours                                                  Must include at least 16 hours     Must include at least 16 hours     80 hours of theory.             30 hours classroom, 75 hours      15 hours laboratory               At least 50% of Part I and Part
classroom and clinical   of supervised practical training                                                of supervised practical training   of supervised practical training   At least 40 hours of            supervised clinical training at   experience and                    2 of the course curriculum
instruction              (training in a laboratory or                                                    (training in a laboratory or       (training in a laboratory or       supervised clininical           least 16 of which must be in      30 hours classroom                shall be provided as clinical
                         other setting in which the                                                      other setting in which the         other setting in which the         experience in an accredited     directly supervised practical     instruction.                      instruction. Clinical instruction
                         trainee demonstrates                                                            trainee demonstrates               trainee demonstrates               nursing training program with   training. Must be conducted                                         must be conducted in an adult
                         knowledge while performing                                                      knowledge while performing         knowledge while performing         demonstrated comptence in       using the Resident Care                                             care home or a licensed LTC
                         tasks on an individual under                                                    tasks on an individual under       tasks on an individual under       the approved manual skills.     Procedures (RCP) manual                                             hospital unit distinct from the
                         the direct supervision of a                                                     the direct supervision of a        the direct supervision of a                                        checklists.                                                         hospital
                         registered nurse or a licensed                                                  registered nurse or a licensed     registered nurse or a licensed
                         practical nurse).                                                               practical nurse).                  practical nurse).




In-service training      Performance evaluation              To maintain certification, a                                                   Performance evaluation                                             In-service training must be       12 hours of in-services
required                 required at least once every        performance review is                                                          required at least once every                                       sufficient to ensure the          training required annually
                         12 months with regular in-          required every 12 months with                                                  12 months with regular in-                                         continuing competence of the      directed towards specific skill
                         service education based on          regular inservice education                                                    service education based on                                         nurse aide, but must be no        improvement and include
                         the outcome of reviews.             based on the outcome of the                                                    the outcome of reviews.                                            less than 12 hours per year       training on working with the
                         -Must be sufficient to ensure       review. Training must be at                                                    -Must be sufficient to ensure                                      and address areas of              cognitively impaired.
                         continuing competence of            least 18 hours per year and                                                    continuing competence of                                           weakness within the               Regular performance review
                         nurse aides, but no less than       sufficient to ensure continuing                                                nurse aides, but no less than                                      performance review, which is      required.
                         12 hours per year.                  competency. Must include at a                                                  12 hours per year.                                                 required once every twelve
                         -Must address areas of              minimum:                                                                       -Must address areas of                                             months.
                         weakness as determined by           -Eating and feeding                                                            weakness as determined by
                         performance evaluation and          techniques;                                                                    performance evaluation and                                         Training program must include:
                         may address special needs of        -Nutrition and hydration                                                       may address special needs of                                       -Resident rights;
                         residents as determined by          principles;                                                                    residents as determined by                                         -Prevention and control of
                         facility staff.                     -Techinques for assisting and                                                  facility staff.                                                    infection;
                         -Must address care of the           responding to the cognitively                                                  -Must address care of the                                          -Fire prevention;
                         cognitively impaired for nurse      impaired or resident with                                                      cognitively impaired for nurse                                     -Safety and accident
                         aides providing those               difficult behaviors;                                                           aides providing those                                              prevention;
                         services.                    Must   -Recognizing changes that                                                      services.                                                          -Needs of specialized
                         include at least 16 hours of        place resident at risk for                                                                                                                        populations served.
                         supervised practical training       pressure ulcers and falls; and
                         (training in a laboratory or        -Address any any of                                                                                                                               Attendance at outside
                         other setting in which the          weakness as determined in                                                                                                                         workshops and continuing
                         trainee demonstrates                the performance review.                                                                                                                           education programs must meet
                         knowledge while performing                                                                                                                                                            the requirements for in-service
                         tasks on an individual under                                                                                                                                                          training.
                         the direct supervision of a
                         registered nurse or a licensed
                         practical nurse).




                                                                                                                                       9/29/2013                                                                                                                                                        Page 7 of 69
                                                                                                     Summary of State CNA Training Regulations


                                  District of Columbia                         Florida               Georgia               Hawaii                                Idaho                              Illinois                         Indiana                           Iowa                          Kansas
Competency exam                                                   Written portion and skills-                  Written or oral competency                                               State approved competency                                        Written or oral portion with a
                                                                  demonstration. An oral exam                  evaluation and clinical skills                                           evaluation, both written and                                     skills demonstration. Exam
                                                                  may substitute the written                   evaluation required.                                                     manual skills components.                                        must be in English unless the
                                                                  exam upon request.                           Competency evaluation can be                                             Any examinee who fails to                                        prevailing language used in the
                                                                  Individuals may "challenge" the              held at NF where candidate is                                            pass the examination with the                                    facility where the aide will be
                                                                  exam without the completion                  employed at candidate's option                                           first 45 days of employment                                      working is other than English.
                                                                  of a training program--                                                                                               must enroll in and complete an                                   Passing score of at least 70%
                                                                  certificate is issued if exam is                                                                                      approved Basic Nursing                                           is required.
                                                                  passed.                                                                                                               Assistant Training program.




Number of attempts            No less than 3 times.               3 times                                      3 times within the 4 months of       No less than 3 times.                                                                                3 times
allowed to pass exam                                                                                           training.
before training must be
repeated
Other requirements            May not charge fees for                                                          State will reimburse training        May not charge fees for             Criminal history records check
                              training or textbooks if nurse                                                   expenses if hired within 12          training or textbooks if nurse      must be initiated prior to entry
                              aide is employed by or has                                                       months of successful                 aide is employed by or has          into training program with
                              received an offer of                                                             completion of training               received an offer of                results attached to the
                              employment from a LTC facility                                                                                        employment from a LTC facility      student's competency test
                              on the date training began; if                                                                                        on the date training began; if      application.
                              the aide receives an offer of                                                                                         the aide receives an offer of
                              employment no later than 12                                                                                           employment no later than 12
                              months after completing                                                                                               months after completing
                              training, state pays for training                                                                                     training, state pays for training
                              on pro rata basis                                                                                                     on pro rata basis




Maximum period                May not use an individual more Within 4 months after initial                     4 months--must be enrolled in        May not use an individual more                                         Students have up to 24         4 months                         4 months--Must complete Part I
individual may work in a      than 4 months on a full-time      employment.                                    training program during this         than 4 months on a full-time                                           months following completion of                                  of training course prior to
facility before meeting       basis unless that individual                                                     period for Medicare or               basis unless that individual                                           the training course to sit for                                  being employed.
training qualifications and   has completed a training and                                                     Medicaid participating facilities.   has completed a training and                                           the final exam.
certification                 competency evaluation                                                                                                 competency evaluation
                              program approved by their                                                                                             program approved by their
                              state. (Part time, per diem, etc.                                                                                     state. (Part time, per diem, etc.
                              employees must meet the                                                                                               employees must meet the
                              same requirements.)                                                                                                   same requirements.)




                                                                                                                                               9/29/2013                                                                                                                                                      Page 8 of 69
                                                                                       Summary of State CNA Training Regulations
                                 District of Columbia                    Florida       Georgia              Hawaii                           Idaho                             Illinois                         Indiana                            Iowa                            Kansas
Course curriculum                                                                                                                                                                                                                                                       Certified Nurse Aide Instructor
specified                                                                                                                                                                                                                                                               Manual, December 1990




Training required prior to   16 hours in communication and                                       16 hours                        16 hours in communication and     16 hours of training in the       16 hours classroom training in 16 hours of classroom training Only a nurse aide trainee II
providing direct care to a   interpersonal skills; infection                                                                     interpersonal skills; infection   following areas:                  the following areas:                                          may provide direct resident
resident                     control; safety and emergency                                                                       control; safety and emergency     -communication and                -Communication and                                            care and only under
                             procedures, including the                                                                           procedures, including the         interpersonal skills;             interpersonal skills;                                         supervision.
                             Heimlich maneuver; promoting                                                                        Heimlich maneuver; promoting      -infection control;               -Infection control;
                             residents' independence;                                                                            residents' independence;          -safety/emergency                 -Safety/emergency
                             respecting residents' rights;                                                                       respecting residents' rights;     procedures, including the         procedures, including Heimlich
                             basic nursing skills; personal                                                                      basic nursing skills; personal    Heimlich maneuver;                maneuver;
                             care skills; mental health and                                                                      care skills; mental health and    -promoting resident's             -Promoting resident's
                             social services of residents;                                                                       social services of residents;     independence; and;                independence;
                             care of cognitively impaired                                                                        care of cognitively impaired      -promoting resident's rights.     -Promoting resident's rights.
                             residents; basic restorative                                                                        residents; basic restorative
                             services; and residents' rights                                                                     services; and residents' rights




Maximum time allowed          24 consecutive months            24 consecutive months             24 consecutive months;          24 consecutive months                                               24 consecutive months              24 consecutive months
before training program                                                                          employer must verify that
and competency exam                                                                              nurse aide provided at least
must be repeated for                                                                             one day (7-8 hours) of nursing/
recertification if individual                                                                    nursing related patient care
has not provided nursing                                                                         within past 24 months; no
or nursing-related                                                                               renewal fee
services for monetary
compensation

Deadlines to complete the                                                                        within 4 months of employment                                     Must successfully complete        Testing applications must be       Examination must be taken and   Must be certified within 4
training course and exam                                                                                                                                           the training program within 120   submitted within 30 days           passed within 4 months of       months from beginning date of
                                                                                                                                                                   days after the date of initial    following completion of the        employment or enrolled in       the initial course in order to
                                                                                                                                                                   employment.                       classroom and clinical training.   training program if a           continue employment providing
                                                                                                                                                                                                                                        permanent employee.             direct individual care. Trainee
                                                                                                                                                                                                                                                                        status for employment shall be
                                                                                                                                                                                                                                                                        for one four-month period
                                                                                                                                                                                                                                                                        only.




                                                                                                                             9/29/2013                                                                                                                                                      Page 9 of 69
                                               Summary of State CNA Training Regulations




              District of Columbia   Florida   Georgia     Hawaii               Idaho   Illinois   Indiana   Iowa   Kansas
Orientation




                                                                    9/29/2013                                            Page 10 of 69
                                                                                                     Summary of State CNA Training Regulations




                                      Kentucky                       Louisiana                       Maine                          Maryland           Massachusetts                Michigan                      Minnesota         Mississippi                  Missouri            Montana
                                                                                                                                                     Level II and Level III
                                                                                                                                                     LTC facilities; Level
                                                                                                                                                     IV facilities that
Type of facility covered   SNF                            SNF                            SNF                           SNF                           employ nurse aides       SNF                      SNF                    SNF                      ICF/SNF                 SNF
Regulatory governing       The Cabinet for Health         Must meet Federal & State      Dept of Human Services -      Maryland Board of Nursing in Dept. of Public           follows OBRA 87--Dept.                          follows OBRA 87; Dept. Must be State approved.   Montana State Dept. of
body/law                   Services--Kentucky Dept. for   requirements--Louisiana Dept   Maine State Board of Nursing; conjunction with the Maryland Health, Division of      of Consumer and                                 of Consumer and                                  Public Health and Human
                           Medicaid Services              of Health & Hospitals          Dept. of Educational and      Higher Education Commission Health Care Quality        Industry Affairs                                Industry Affairs                                 Services
                                                                                         Cultural Services, Bureau of
                                                                                         Workforce Education

Authorized training                                                                                                                                    vocational h.s.,                                                                                                        Must meet state's core
providers                                                                                                                                              community colleges,                                                                                                     curriculum requirements
                                                                                                                                                       LTC facilities,
                                                                                                                                                       temporary help
                                                                                                                                                       agencies


Training program           75 hours                       80 hours                       250 hours                      100 hours                      75 hours; contact    No fewer than 75 clock     75 hours               No fewer than 75 clock                           75 hours; 16 hours must
requirements                                                                                                                                           hour = 50 minutes of hours of training.                                hours of training.                               be supervised clinical
                                                                                                                                                       instruction                                                                                                             training--state
                                                                                                                                                                                                                                                                               regulations; (45-55
                                                                                                                                                                                                                                                                               classroom hours and 25-
                                                                                                                                                                                                                                                                               30 clinical hours given
                                                                                                                                                                                                                                                                               as the acceptable range
                                                                                                                                                                                                                                                                               in state guidelines)




                                                                                                                                                    9/29/2013                                                                                                                           Page 11 of 69
                                                                                                       Summary of State CNA Training Regulations

                                  Kentucky                           Louisiana                           Maine                         Maryland              Massachusetts                  Michigan                    Minnesota                     Mississippi                  Missouri                      Montana
Minimum hours of         Minimum of 16 hours of           40 classroom hours. Facility-     80 hours of classroom, 20       60 hours classroom and 40      Demonstrate all skills   Must include at least 16                                   Must include at least 16 75 hours classrom and 100
classroom and clinical   supervised practical training.   based programs must use the       hours of skills laboratory, and hours clinical training.       on the evaluation        hours of supervised                                        hours of supervised       hours - must precede the final
instruction                                               core curriculum objectives and    50 hours of supervised clinical                                form specified in the    practical training                                         practical training        examination.
                                                          adapt content and skills          practice. (breakdown for the                                   guidelines.              (training in a laboratory                                  (training in a laboratory
                                                          training to the specific          old 150 hr. requirement)                                                                or other setting in which                                  or other setting in which
                                                          population.                                                                                                               the trainee                                                the trainee
                                                                                                                                                                                    demonstrates                                               demonstrates
                                                                                                                                                                                    knowledge while                                            knowledge while
                                                                                                                                                                                    performing tasks on an                                     performing tasks on an
                                                                                                                                                                                    individual under the                                       individual under the
                                                                                                                                                                                    direct supervision of a                                    direct supervision of a
                                                                                                                                                                                    registered nurse or a                                      registered nurse or a
                                                                                                                                                                                    licensed practical                                         licensed practical
                                                                                                                                                                                    nurse).                                                    nurse).




In-service training      12 hours required annually.      Three hours training per                                                                                                  Performance evaluation      Regular in-service training    Performance evaluation                                     Must have 12 hours of
required                                                  quarter. Can be received on                                                                                               required at least once      required based on outcome of   required at least once                                     inservice training per
                                                          the unit as long a directed                                                                                               every 12 months with        annual performance review--    every 12 months with                                       calendar year.
                                                          toward skills improvement,                                                                                                regular in-service          no less than 12 hours per      regular in-service                                         Can be remedial skills,
                                                          provided by appropriate                                                                                                   education based on the      year. Must address care of     education based on the                                     nursing and nursing
                                                          trained staff and documented.                                                                                             outcome of reviews.         the cognitively impaired for   outcome of reviews.                                        related skills, meeting
                                                          License renewal is                                                                                                        -Must be sufficient to      aides providing those          -Must be sufficient to                                     mental, physical, and
                                                          automatically done by registry                                                                                            ensure continuing           services.                      ensure continuing                                          psychosocial needs,
                                                          biannually. Proof of continuing                                                                                           competence of nurse                                        competence of nurse                                        CPR, self-growth
                                                          education will be done during                                                                                             aides, but no less than                                    aides, but no less than                                    (stress management,
                                                          the facility's annual review by                                                                                           12 hours per year.                                         12 hours per year.                                         time management,
                                                          the state agency.                                                                                                         -Must address areas of                                     -Must address areas of                                     interpersonal skills),
                                                                                                                                                                                    weakness as                                                weakness as                                                written/oral
                                                                                                                                                                                    determined by                                              determined by                                              communication,
                                                                                                                                                                                    performance evaluation                                     performance evaluation                                     observation and
                                                                                                                                                                                    and may address                                            and may address                                            documentation,
                                                                                                                                                                                    special needs of                                           special needs of                                           promotion of resident
                                                                                                                                                                                    residents as determined                                    residents as determined                                    rights and dignity
                                                                                                                                                                                    by facility staff.                                         by facility staff.
                                                                                                                                                                                    -Must address care of                                      -Must address care of
                                                                                                                                                                                    the cognitively impaired                                   the cognitively impaired
                                                                                                                                                                                    for nurse aides                                            for nurse aides
                                                                                                                                                                                    providing those                                            providing those
                                                                                                                                                                                    services.                                                  services.




                                                                                                                                                        9/29/2013                                                                                                                                                   Page 12 of 69
                                                                                           Summary of State CNA Training Regulations


                                     Kentucky                       Louisiana                 Maine                          Maryland                  Massachusetts                    Michigan                  Minnesota                  Mississippi                  Missouri                        Montana
Competency exam            Written or oral exam with a                          pass/fail recommended for        Written final exam plus             Dept. of Public           Role of nurse assistant, Written or oral exam plus a   Role of nurse assistant, Oral or written plus completion   Headmaster designated
                           skills demonstration                                 skills; instructor decides how   demonstrated skills                 Health; can be            18%; Promotion of        skills demonstration.         18%; Promotion of        of at least 9 specific            the testing firm; also
                           component-administered by                            many attempts are possible       performance-trainees are            written or oral;          health and safety, 15%;                                health and safety, 15%; procedures.                        American Red Cross
                           the Kentucky Community and                                                            evaluted on their ability to meet   quesitons can be          Promotion of function                                  Promotion of function                                      Exam can be written or
                           Technical College System,                                                             the program objectives in the       simplified if given       and health of residents,                               and health of residents,                                   oral; 5 randomly
                           Technical College Branch.                                                             classrooom, laboratory and          orally; must answer       27%; Basic nursing                                     27%; Basic nursing                                         selected skills tested--
                                                                                                                 clinical setting.                   all questions listed in   skills, 25%; Specialized                               skills, 25%; Specialized                                   pool must include all
                                                                                                                                                     the evaluation form       care, 15%. Skills                                      care, 15%. Skills                                          personal care skills, and
                                                                                                                                                                               demonstration will                                     demonstration will                                         2 skills must be personal
                                                                                                                                                                               include 3 tasks.                                       include 3 tasks.                                           care skills. Passing is
                                                                                                                                                                                                                                                                                                 75% on the written/oral
                                                                                                                                                                                                                                                                                                 exam and 80% on each
                                                                                                                                                                                                                                                                                                 skills subtest--including
                                                                                                                                                                                                                                                                                                 passing all key points
                                                                                                                                                                                                                                                                                                 (must pass 3 of the 5
                                                                                                                                                                                                                                                                                                 skills tests)


Number of attempts         3 opportunities within a 4                                                            3 times                                                       No less than 3 times.                                  No less than 3 times.                                      3 times
allowed to pass exam       month period.
before training must be
repeated
Other requirements                                                                                               CNAs working in long-term                                     May not charge fees for                                May not charge fees for                                    May not charge fees for
                                                                                                                 care facilities must be                                       training or textbooks if                               training or textbooks if                                   course or textbook to
                                                                                                                 registered as a GNA (Geriatric                                nurse aide is employed                                 nurse aide is employed                                     nurse aide who is
                                                                                                                 Nurse Assistant) within 120                                   by or has received an                                  by or has received an                                      employed or who has
                                                                                                                 days of employment.                                           offer of employment                                    offer of employment                                        offer of employment at
                                                                                                                                                                               from a LTC facility on                                 from a LTC facility on                                     beginning of course;
                                                                                                                                                                               the date training began;                               the date training began;                                   state will reimburse
                                                                                                                                                                               if the aide receives an                                if the aide receives an                                    nurse aide who
                                                                                                                                                                               offer of employment no                                 offer of employment no                                     becomes employed
                                                                                                                                                                               later than 12 months                                   later than 12 months                                       within 12 months of
                                                                                                                                                                               after completing training,                             after completing training,                                 completing course
                                                                                                                                                                               state pays for training                                state pays for training
                                                                                                                                                                               on pro rata basis                                      on pro rata basis

Maximum period              4 months                     4 months                                                                                    90 days to complete May not use an             4 months                          May not use an           4 months                          4 months
individual may work in a                                                                                                                             training; 180 days to individual more than 4                                     individual more than 4
facility before meeting                                                                                                                              complete evaulation months on a full-time                                        months on a full-time
training qualifications and                                                                                                                                                basis unless that                                          basis unless that
certification                                                                                                                                                              individual has completed                                   individual has completed
                                                                                                                                                                           a training and                                             a training and
                                                                                                                                                                           competency evaluation                                      competency evaluation
                                                                                                                                                                           program approved by                                        program approved by
                                                                                                                                                                           their state. (Part time,                                   their state. (Part time,
                                                                                                                                                                           per diem, etc.                                             per diem, etc.
                                                                                                                                                                           employees must meet                                        employees must meet
                                                                                                                                                                           the same requirements.)                                    the same requirements.)




                                                                                                                                                9/29/2013                                                                                                                                                   Page 13 of 69
                                                                                                         Summary of State CNA Training Regulations
                                      Kentucky                        Louisiana                            Maine                         Maryland                 Massachusetts                 Michigan                     Minnesota            Mississippi                       Missouri                         Montana
Course curriculum            Study aid--Kentucky Medicaid                                     A Curriculum Guide for                                            use minimum                                                                                              Nurse Assistant in a Long-         Red Cross           AHCA
specified                    Nurse Aide Testing                                               Assistants to Nurses, MDOE/                                       standard curriculum,                                                                                     Term Care Facility produced        (How To Be a Nurse
                             Procedures Manual and Study                                      MSBN guide January 2000;                                          plus any training                                                                                        by the Instructional Materials     Assistant)
                             Guide                                                            Prescribed Bridge Course for                                      required for special                                                                                     Laboratory, Univ of Missouri-      ProCare (35 hours
                                                                                              Nursing Assistant Training                                        resident populations;                                                                                    Columbia, 1987. Other course       classroom training only)
                                                                                              shall be used for nursing                                         curriculum                                                                                               materials may be used to           Headmaster on Site and
                                                                                              assistants who have                                               organization and                                                                                         supplement the curriculum.         Distance Learning
                                                                                              completed at least 75 hours of                                    teaching strategies                                                                                                                         Being a Nurse Asst. &
                                                                                              training but less than the                                        at discretion of                                                                                                                            LTC Nursing Asst.
                                                                                              required 150 hours. The                                           instructor;                                                                                                                                 (Brady/P-H); Nursing
                                                                                              bridge course must include 40                                     instructors submit                                                                                                                          Asst. & Assisting in LTC
                                                                                              hours classroom instruction                                       curriculum to Dept.                                                                                                                         (Delmar); Textbook for
                                                                                              and 35 hours of combined                                          of Public Health, Div.                                                                                                                      LTC (Mosby); Nursing
                                                                                              skills laboratory and                                             of Health Care                                                                                                                              Asst. Study Guide (1st
                                                                                              supervised clinical practice.                                     Quality for approval                                                                                                                        Class Books); How To
                                                                                                                                                                                                                                                                                                            Be a Nurse Asst.
                                                                                                                                                                                                                                                                                                            (AHCA)
Training required prior to                                  16 hours classroom training.                                       16 hours classroom training      any tasks for which      16 hours in                                         16 hours in                                                    16 hours of classroom
providing direct care to a                                  Plus 16 or more hours in skills                                                                     they have been           communication and                                   communication and                                              training
resident                                                    training.                                                                                           trained and              interpersonal skills;                               interpersonal skills;                                          (communications,
                                                                                                                                                                demonstrated ability     infection control; safety                           infection control; safety                                      interpersonal skills,
                                                                                                                                                                to perform               and emergency                                       and emergency                                                  patient rights, basic
                                                                                                                                                                                         procedures, including                               procedures, including                                          infection control,
                                                                                                                                                                                         the Heimlich maneuver;                              the Heimlich maneuver;                                         fostering independence
                                                                                                                                                                                         promoting residents'                                promoting residents'                                           and safety and
                                                                                                                                                                                         independence;                                       independence;                                                  emergency procedures,
                                                                                                                                                                                         respecting residents'                               respecting residents'                                          including the Heimlich
                                                                                                                                                                                         rights; basic nursing                               rights; basic nursing                                          maneuver, basic nursing
                                                                                                                                                                                         skills; personal care                               skills; personal care                                          skills, personal care
                                                                                                                                                                                         skills; mental health and                           skills; mental health and                                      skills)
                                                                                                                                                                                         social services of                                  social services of
                                                                                                                                                                                         residents; care of                                  residents; care of
                                                                                                                                                                                         cognitively impaired                                cognitively impaired
                                                                                                                                                                                         residents; basic                                    residents; basic
                                                                                                                                                                                         restorative services;                               restorative services;
                                                                                                                                                                                         and residents' rights                               and residents' rights
Maximum time allowed          24 consecutive months         24 consecutive months                                              Must be renewed every 2      24 consecutive               24 consecutive months       24 consecutive months   24 consecutive months                                          Must be renewed
before training program                                                                                                        years. Must provide evidence months                                                                                                                                          biennially. Can renew if
and competency exam                                                                                                            of 8 hours of active                                                                                                                                                         worked as nurse aide
must be repeated for                                                                                                           employment within the 1-year                                                                                                                                                 for pay for minimum of 8
recertification if individual                                                                                                  period immediately preceding                                                                                                                                                 hours during 2-year
has not provided nursing                                                                                                       date of renewal.                                                                                                                                                             period.
or nursing-related
services for monetary
compensation

Deadlines to complete the                                   Training organizations must                                        Exam must be completed         90 days to complete                                                                                        Complete entire course plus
training course and exam                                    report names of individuals                                        within 12 months of completion training; 180 days to                                                                                      pass exam within 1 year of
                                                            who have satisfactorily                                            of training.                   complete evaulation                                                                                        employment. 4 months if
                                                            completed training within 30                                                                                                                                                                                 employed by a facility certified
                                                            days after their completion of                                                                                                                                                                               under Title XVIII or Title XIX.
                                                            training so testing may be
                                                            scheduled.




                                                                                                                                                             9/29/2013                                                                                                                                               Page 14 of 69
                                                          Summary of State CNA Training Regulations




              Kentucky              Louisiana             Maine      Maryland       Massachusetts          Michigan   Minnesota   Mississippi               Missouri                Montana
Orientation              Orientation program given in a                            Required during first                                        Orientation module is required.
                         nursing facility-based program                            40 hours of                                                  At least 16 hrs for Medicare/
                         (not included in 80 hours of                              employment                                                   Medicaid certified facilities and
                         training).                                                                                                             12 hours of supervised
                                                                                                                                                practical orientation. At least
                                                                                                                                                12 hrs. for licensed only
                                                                                                                                                facilities.




                                                                                9/29/2013                                                                                            Page 15 of 69
                                                                                    Summary of State CNA Training Regulations




                                    Nebraska                        Nevada             New Hampshire             New Jersey                          New Mexico                     New York                   North Carolina             North Dakota                     Ohio




Type of facility covered   SNF/ICF/ICFMR                 SNF                     SNF                      SNF                              SNF/ICF                          SNF                         SNF                                    SNF             SNF
Regulatory governing       Nebraska Dept of Health and   Nevada State Board of   New Hampshire Board of   Dept. of Health and Senior       New Mexico Dept of Health,       NY Code 415.26 and 415.31   follows OBRA 87--Code of       ND Dept. of Health      Ohio Board of Nursing
body/law                   Human Services Regulation     Nursing                 Nursing                  Services                         Public Health Division, Health                               Federal Regulations 42, Part
                           and Licensure Credentialing                                                                                     Facility Licensing and                                       483
                           Division                                                                                                        Certification Bureau


Authorized training                                                                                       LTC facility; county                                                                                                         manual skills--under
providers                                                                                                 vocational school; county                                                                                                    supervision of
                                                                                                          community college;                                                                                                           approved training
                                                                                                          proprietary program                                                                                                          program and qualified
                                                                                                                                                                                                                                       instructor


Training program           115 hours to include:         75 hours                100 hours                75 hours                                                          100 hours                   No fewer than 75 clock hours 75 hours           16 100 hours divided between
requirements               Basic Resident Care Course-                                                                                                                                                  of training.                 hours must be         skills training and classroom
                           75 hours                                                                                                                                                                                                  supervised practical instruction.
                           Advanced Course - 40 hours                                                                                                                                                                                training




                                                                                                                               9/29/2013                                                                                                                                               Page 16 of 69
                                                                                               Summary of State CNA Training Regulations

                                    Nebraska                        Nevada                       New Hampshire                      New Jersey                      New Mexico                            New York                   North Carolina               North Dakota                      Ohio
Minimum hours of         Basic Care Course must          No less than 60 hours of          40 hours theory (classroom); 50 hours classroom; 16                                                 Must include at least 30      Must include at least 16 hours 16 hours minimum         100 hours divided between
classroom and clinical   include a minimum:              theory and learning skills in a   60 hours of concurrent clinical hours of supervised practical                                       hours of supervised practical of supervised practical training (before contact with   skills training and classroom
instruction              15 hrs classroom instruction in laboratory setting.               experience                      training                                                            training in a nursing home    (training in a laboratory or     residents)             instruction.
                         basic personal care;                                                                                                                                                                                other setting in which the
                         5 hrs classroom instruction in                                                                                                                                                                      trainee demonstrates
                         basic therapeutic and                                                                                                                                                                               knowledge while performing
                         emergency procedures;                                                                                                                                                                               tasks on an individual under
                         1 hr of instruction on                                                                                                                                                                              the direct supervision of a
                         procedures for reporting                                                                                                                                                                            registered nurse or a licensed
                         abuse or neglect.                                                                                                                                                                                   practical nurse).

                         Advanced Course must
                         include:
                         30 hrs classroom instruction in
                         anatomy and physiology and
                         advanced therapeutics
                         (marked AC below).
                         40 hours classroom instruction
                         in pharmacology, medication
                         administration, and oxygen
                         administration by means of an
                         oxygen concentrator.

In-service training      Must attend quarterly in-         30 hours in a program of                                                                         Quarterly in-service training to   Performance evaluation           Performance evaluation                               At least 12 hours of regular in-
required                 service programs with topics      continuing education required                                                                    be provided designed to            required at least once every     required at least once every                         service education required per
                         dealing in medications or         in the 2-year period before                                                                      improve employee skills and        12 months with regular in-       12 months with regular in-                           year based on outcomes of
                         medication administration.        renewal of certification.                                                                        knowledge (needs of                service education based on       service education based on                           regular performance reviews.
                         Must also satisfactorily                                                                                                           residents, rehabilitative          the outcome of reviews.          the outcome of reviews.                              To address weaknesses
                         complete the medication                                                                                                            therapy, oral health,              -Must be sufficient to ensure    -Must be sufficient to ensure                        identified in the review
                         examination every 3 years.                                                                                                         wheelchair safety and              continuing competence of         continuing competence of                             process and include care for
                                                                                                                                                            transportation, special            nurse aides, but no less than    nurse aides, but no less than                        the congitively impaired for
                         Ongoing training must consist                                                                                                      programming for                    12 hours per year.               12 hours per year.                                   aides providing those
                         of at least 12 hours per year                                                                                                      developmentally disabled)          -Must address areas of           -Must address areas of                               services.
                         on topics appropriate to the                                                                                                                                          weakness as determined by        weakness as determined by
                         employee's job duties,                                                                                                                                                performance evaluation and       performance evaluation and
                         including meeting the physical,                                                                                                                                       may address special needs        may address special needs of
                         psychosocial, and mental                                                                                                                                              of residents as determined       residents as determined by
                         needs of residents.                                                                                                                                                   by facility staff.               facility staff.
                                                                                                                                                                                               -Must address care of the        -Must address care of the
                                                                                                                                                                                               cognitively impaired for nurse   cognitively impaired for nurse
                                                                                                                                                                                               aides providing those            aides providing those
                                                                                                                                                                                               services.                        services.




                                                                                                                                                9/29/2013                                                                                                                                                   Page 17 of 69
                                                                                                      Summary of State CNA Training Regulations


                                      Nebraska                            Nevada                         New Hampshire                        New Jersey               New Mexico            New York                        North Carolina                   North Dakota                   Ohio
Competency exam             Advanced Care Course - must      On completing training               Written/oral and skills           Candidate can choose                                                                                                  written or oral exam;
                            score at least 80% based on      program, individual must pass        examination must be               between written and oral                                                                                              manual skills
                            written and clinical             a test in theory with an overall     completed within 2 years          exam. Oral exam must be                                                                                               exam questions from
                            components.                      score of 80% and a test of           immediately prior to license      read in a neutral manner from                                                                                         a pool; manual skills
                            Exam is given once per course    skills on a pass or fail basis. If   application. A grade of 70%       a prepared text. Exam                                                                                                 randomly selected
                            year. No retakes are permitted   either of these tests is failed,     or greater is required in exam    developed from pool of test                                                                                           from those used by
                            unless the course is repeated.   training must be repeated in         testing for theoretical content   questions. Skills randomly                                                                                            nurse aides; no
                                                             the deficient areas.                 and a grade of "pass" on skills   selected from pool which                                                                                              charge for exam if
                                                                                                  test.                             includes all the personal care                                                                                        employed by NF or
                                                                                                                                    skills (bathing, grooming,                                                                                            have offer of
                                                                                                                                    mouth care, dressing,                                                                                                 employment; exam
                                                                                                                                    toileting, assisting with eating                                                                                      can't be administered
                                                                                                                                    and hydration, proper feeding                                                                                         or evaluated by a
                                                                                                                                    techniques, skin care,                                                                                                SNF, but SNF can
                                                                                                                                    transfers, positioning,                                                                                               proctor written exam
                                                                                                                                    turning)


Number of attempts          Exam is given once per course 3 times                                                                   3 times                                         No less than 3 times.             No less than 3 times.               3 times
allowed to pass exam        year. No retakes are permitted
before training must be     unless the course is repeated.
repeated
Other requirements          Must be retested every 3        Fingerprinting required.                                                Does not require nurse aide                     May not charge fees for           May not charge fees for             Nurse aides who are No LTC facility shall impose a
                            years on medication                                                                                     certification if working in a                   training or textbooks if nurse    training or textbooks if nurse      employed or have      charge for training or
                            administration with passing                                                                             hospital. But does have to                      aide is employed by or has        aide is employed by or has          offers of employment textbooks
                            score of at least 80%--cannot                                                                           complete the training program                   received an offer of              received an offer of                from a NF may not be
                            be taken sooner than 6 months                                                                           If the hospital has a licensed                  employment from a LTC             employment from a LTC facility      charged for training,
                            before expiration fo the 3 year                                                                         LTC unit or sub-acute unit.                     facility on the date training     on the date training began; if      including textbooks
                            approved period. The 3-year                                                                             No charge for training if                       began; if the aide receives       the aide receives an offer of
                            exam is administered at least 4                                                                         employed or has offer of                        an offer of employment no         employment no later than 12
                            times per year.                                                                                         employment, or is employed                      later than 12 months after        months after completing
                                                                                                                                    within 12 months of                             completing training, state        training, state pays for training
                                                                                                                                    completing training program.                    pays for training on pro rata     on pro rata basis
                                                                                                                                                                                    basis


Maximum period              Must complete a Basic            4 months                                                                                                               May not use an individual         May not use an individual more 4 months                     4 months; must wear a name
individual may work in a    Resident Care Course within                                                                                                                             more than 4 months on a full-     than 4 months on a full-time                                tag identifying them as a
facility before meeting     120 days of employment.                                                                                                                                 time basis unless that            basis unless that individual                                trainee during this period
training qualifications and                                                                                                                                                         individual has completed a        has completed a training and
certification                                                                                                                                                                       training and competency           competency evaluation
                                                                                                                                                                                    evaluation program approved       program approved by their
                                                                                                                                                                                    by their state. (Part time, per   state. (Part time, per diem, etc.
                                                                                                                                                                                    diem, etc. employees must         employees must meet the
                                                                                                                                                                                    meet the same                     same requirements.)
                                                                                                                                                                                    requirements.)




                                                                                                                                                           9/29/2013                                                                                                                                  Page 18 of 69
                                                                                                   Summary of State CNA Training Regulations
                                         Nebraska                          Nevada                    New Hampshire                      New Jersey               New Mexico            New York                       North Carolina                North Dakota                 Ohio
Course curriculum                                                                                                                                                                                                                                Any approved by the
specified                                                                                                                                                                                                                                        Dept. of Health




Training required prior to                                                                                                       16 hours                                     16 hours in communication        16 hours in communication and     16 hours classroom
providing direct care to a                                                                                                                                                    and interpersonal skills;        interpersonal skills; infection   training in
resident                                                                                                                                                                      infection control; safety and    control; safety and emergency     communication and
                                                                                                                                                                              emergency procedures,            procedures, including the         interpersonal skills;
                                                                                                                                                                              including the Heimlich           Heimlich maneuver; promoting      infection control;
                                                                                                                                                                              maneuver; promoting              residents' independence;          safety & emergency
                                                                                                                                                                              residents' independence;         respecting residents' rights;     procedures (including
                                                                                                                                                                              respecting residents' rights;    basic nursing skills; personal    Heimlich Maneuver);
                                                                                                                                                                              basic nursing skills; personal   care skills; mental health and    promoting residents'
                                                                                                                                                                              care skills; mental health and   social services of residents;     independence;
                                                                                                                                                                              social services of residents;    care of cognitively impaired      respecting residents'
                                                                                                                                                                              care of cognitively impaired     residents; basic restorative      rights
                                                                                                                                                                              residents; basic restorative     services; and residents' rights
                                                                                                                                                                              services; and residents'
                                                                                                                                                                              rights




Maximum time allowed            Must retake the 40 hours         Must be renewed biennially.   Must be renewed biennially--                                                   24 consecutive months            24 consecutive months             24 consecutive       24 consecutive months
before training program         pharmacology and medication                                    must document having                                                                                                                              months--must perform
and competency exam             administration portion of the                                  provided nursing-related                                                                                                                          nursing services for
must be repeated for            advanced care course (with                                     activites for 450 hours within                                                                                                                    pay for at least 8
recertification if individual   passing grade of at least 80%)                                 2 years immediately prior to                                                                                                                      hours during that
has not provided nursing        if individual has not worked for                               the application date.                                                                                                                             period or re-take
or nursing-related              a period of 3 or more years.                                                                                                                                                                                     training course
services for monetary
compensation

Deadlines to complete the                                                                      Must be certified within 120                                                                                                                      after first 16 hours, 4
training course and exam                                                                       days from the date of the                                                                                                                         months to complete
                                                                                               training program's first class.                                                                                                                   training in SNF after
                                                                                                                                                                                                                                                 employment




                                                                                                                                                     9/29/2013                                                                                                                            Page 19 of 69
                                                        Summary of State CNA Training Regulations




                          Nebraska             Nevada   New Hampshire   New Jersey                         New Mexico                        New York             North Carolina   North Dakota                Ohio
Orientation   An initial orientation must be                                                     Before perfoming any duties,      required--see curriculum for                                   At least 120 minutes in length
              provided within 2 weeks that                                                       employees must receive an         orientation                                                    including the organizational
              includes:                                                                          orientation to the facility and                                                                  structure of the facility,
              -Resident rights;                                                                  its policies including fire/                                                                     policies and procedures,
              -Emergency procedures -fire                                                        accident prevention,                                                                             philosophy of care, description
              safety and disaster                                                                emergency procedures.                                                                            of the resident population, and
              preparedness;                                                                      Orientation on resident rights                                                                   employee rules.
              -Info on abuse, neglect,                                                           and specific duties must be
              misappropriation of money or                                                       provided within 30 days.
              property of a resident,
              reporting requirements and
              facility procedures;
              -Job duties and
              responsibilities;
              -Medical emergency
              directives.




                                                                                     9/29/2013                                                                                                                          Page 20 of 69
                                                                                           Summary of State CNA Training Regulations




                                      Oklahoma                      Oregon                        Pennsylvania          Rhode Island                 South Carolina               South Dakota                       Tennessee                        Texas              Utah




Type of facility covered   SNF                           SNF                               SNF                         SNF                 SNF or NF                     SNF                                  SNF                         SNF                              SNF
Regulatory governing       Oklahoma State Dept. of Health Oregon State Board of Nursing Pennsylvania Dept. of          Dept. of Health     SC Dept. of Health and           South Dakota Board of Nursing Tennessee Dept of Health,       Texas Dept of Human   Utah Dept. of Health,
body/law                                                                                Education                                          Environmental Control,                                         Division of Health              Services              Division of Health Care
                                                                                                                                           Division of Certification, Nurse                                                                                     Financing (State Office
                                                                                                                                           Aide Training Program                                                                                                of Vocational Education
                                                                                                                                                                                                                                                                administers training
                                                                                                                                                                                                                                                                program)
Authorized training                                      training programs must be                                     not specified--     Facilities in good standing                                                                                          vocational center,
providers                                                approved by Oregon State                                      any authorized      with State Licensure and                                                                                             community college,
                                                         Board of Nursing                                              provider            Certification Division                                                                                               nursing facility




Training program           75 hours                      150 hours of training.            No fewer than 75 clock hours 100 hours          80 hours                      75 hours of classroom and            No fewer than 75 clock hours 75 hours             80 hours (including at
requirements                                             Training curricula and            of training.                                                                  clinical training (skills training   of training.                                      least 16 hours of
                                                         standards shall provide for                                                                                     must be at least 16 hours)                                                             practical training)
                                                         additional training for nursing
                                                         assistants to administer
                                                         noninjectable medications.




                                                                                                                                         9/29/2013                                                                                                                                       Page 21 of 69
                                                                                          Summary of State CNA Training Regulations

                                    Oklahoma                         Oregon                        Pennsylvania               Rhode Island                South Carolina               South Dakota                        Tennessee                        Texas            Utah
Minimum hours of         At least 16 hours supervised   75 hours of supervised clinical   Must include at least 16 hours     80 hours            40 hours of classroom          16 hours clinical                Must include at least 16 hours 51 hours classroom; 24
classroom and clinical   practical training.            experience--at least 40 hours     of supervised practical training   classroom; 20       instruction and 40 hours of                                     of supervised practical        hours of clinical training
instruction              Assisted Living Residential    in a licensed nursing facility.   (training in a laboratory or       hours clinical.     clinical experience in a LTC                                    training (training in a
                         Care Aide--45 hours of         Clinical portion must be          other setting in which the                             facility                                                        laboratory or other setting in
                         classroom and supervised       completed no later than 3         trainee demonstrates                                                                                                   which the trainee
                         practical training or the      months following the last date    knowledge while performing                                                                                             demonstrates knowledge
                         equivalent.                    of classroom instruction.         tasks on an individual under                                                                                           while performing tasks on an
                                                                                          the direct supervision of a                                                                                            individual under the direct
                                                                                          registered nurse or a licensed                                                                                         supervision of a registered
                                                                                          practical nurse).                                                                                                      nurse or a licensed practical
                                                                                                                                                                                                                 nurse).




In-service training                                                                       Performance evaluation                                 12 hours in-service required   Minimum of 12 hours in-          Performance evaluation
required                                                                                  required at least once every                           per year.                      service education related to     required at least once every
                                                                                          12 months with regular in-                                                            results of performance review    12 months with regular in-
                                                                                          service education based on                                                            and of special resident needs.   service education based on
                                                                                          the outcome of reviews.                                                                                                the outcome of reviews.
                                                                                          -Must be sufficient to ensure                                                                                          -Must be sufficient to ensure
                                                                                          continuing competence of                                                                                               continuing competence of
                                                                                          nurse aides, but no less than                                                                                          nurse aides, but no less than
                                                                                          12 hours per year.                                                                                                     12 hours per year.
                                                                                          -Must address areas of                                                                                                 -Must address areas of
                                                                                          weakness as determined by                                                                                              weakness as determined by
                                                                                          performance evaluation and                                                                                             performance evaluation and
                                                                                          may address special needs of                                                                                           may address special needs of
                                                                                          residents as determined by                                                                                             residents as determined by
                                                                                          facility staff.                                                                                                        facility staff.
                                                                                          -Must address care of the                                                                                              -Must address care of the
                                                                                          cognitively impaired for nurse                                                                                         cognitively impaired for nurse
                                                                                          aides providing those                                                                                                  aides providing those
                                                                                          services.                                                                                                              services.




                                                                                                                                               9/29/2013                                                                                                                            Page 22 of 69
                                                                                             Summary of State CNA Training Regulations


                                     Oklahoma                        Oregon                          Pennsylvania                 Rhode Island             South Carolina                 South Dakota                    Tennessee                           Texas                            Utah
Competency exam            Written or oral portion in     Must achieve a passing score                                                               Candidates may challenge the Written or oral plus skills   Passing grade of 75% for the      Must pass the skills and          Written or oral exam and
                           English--must score at least   of 75% or higher. Written and                                                              exam without a state         demonstration.                written or oral component and     written portion (50-70 multiple   a skills demonstration
                           70%. Skills examination        manual skills examination,                                                                 approved training program.                                 correct completion of 2 of 3      choice items selected from        (randomly selected
                           portion--must score at least   administered in English.                                                                                                                              clinical skills in the skills     pool which must include each      skills)
                           80%.                           English as a second language                                                                                                                          component. Written or oral        item of course curriculum;        Must have 80% to pass.
                                                          does not quality for special                                                                                                                          tests will not be more than       oral exam can be in English
                                                          testing accommodation.                                                                                                                                100 questions. Exam can be        or Spanish) of the
                                                          Dictionaries and translators                                                                                                                          given at the facility where the   competency evaluation
                                                          not allowed.          Facilities                                                                                                                      candidate is employed, at the     program (CEP); exam can be
                                                          expected to have 85% pass                                                                                                                             candidate's option.               written or oral (oral by
                                                          rate.                                                                                                                                                                                   request by tape recording
                                                                                                                                                                                                                                                  which also tests reading
                                                                                                                                                                                                                                                  comprehension); tested on 5
                                                                                                                                                                                                                                                  randomly selected skills
                                                                                                                                                                                                                                                  selected from a pool of 34
                                                                                                                                                                                                                                                  skills, which must contain all
                                                                                                                                                                                                                                                  the personal care skills

Number of attempts         3 times                        3 times                            No less than 3 times.               3 times                                                                        No less than 3 times.             3 times                     3 times (State Office of
allowed to pass exam                                                                                                                                                                                                                                                          Vocational Education
before training must be                                                                                                                                                                                                                                                       can set maximum, but at
repeated                                                                                                                                                                                                                                                                      least 3 times)
Other requirements                                        Must complete adult CPR            May not charge fees for             testing fees of                                                                May not charge fees for         Aide who is employed when Costs of training and
                                                          certification in accordance        training or textbooks if nurse      $20 for written                                                                training or textbooks if nurse training starts may not be     testing paid by the
                                                          with Board approved                aide is employed by or has          and $25 for                                                                    aide is employed by or has      charged for instruction or    nursing facility,
                                                          curriculum.                        received an offer of                clinical exams;                                                                received an offer of            textbooks; will be reimbursed reimbursed through per
                                                          For facility-based training        employment from a LTC facility      waived if                                                                      employment from a LTC           by the state if employed      diem rates set by
                                                          programs, no student who is        on the date training began; if      employed for 6                                                                 facility on the date training   within 12 months of training Division of Health Care
                                                          employed or has an offer of        the aide receives an offer of       consecutive                                                                    began; if the aide receives an                                Financing--paid by
                                                          employment from a facility will    employment no later than 12         months in SNF                                                                  offer of employment no later                                  Medicare and Medicaid;
                                                          be charged for training,           months after completing                                                                                            than 12 months after                                          no nurse aide may be
                                                          including textbooks.               training, state pays for training                                                                                  completing training, state pays                               charged, including for
                                                                                             on pro rata basis                                                                                                  for training on pro rata basis                                textbooks, but aide must
                                                                                                                                                                                                                                                                              work minimum of one
                                                                                                                                                                                                                                                                              year to be reimbursed to
                                                                                                                                                                                                                                                                              facility
Maximum period              4 months                      4 months. Cannot be                May not use an individual more      120 days; can                                      4 months                    May not use an individual       4 months
individual may work in a                                  employed for a period of more      than 4 months on a full-time        only provide                                                                   more than 4 months on a full-
facility before meeting                                   than 8 weeks without training      basis unless that individual        care for which                                                                 time basis unless that
training qualifications and                               being provided.                    has completed a training and        student has                                                                    individual has completed a
certification                                                                                competency evaluation               demonstrated                                                                   training and competency
                                                                                             program approved by their           competency                                                                     evaluation program approved
                                                                                             state. (Part time, per diem, etc.                                                                                  by their state. (Part time, per
                                                                                             employees must meet the                                                                                            diem, etc. employees must
                                                                                             same requirements.)                                                                                                meet the same requirements.)




                                                                                                                                                   9/29/2013                                                                                                                                             Page 23 of 69
                                                                                                   Summary of State CNA Training Regulations
                                           Oklahoma                           Oregon                      Pennsylvania                Rhode Island              South Carolina                       South Dakota                    Tennessee                        Texas                         Utah
Course curriculum                                                 textbook must appear on                                                                must include 13 theory topics:    AHCA--How To Be a Nurse
specified                                                         Oregon State Board of Nursing                                                          functions & responsibility of     Assistant (includes ProCare
                                                                  list of approved texts.                                                                the nurse aide;                   IVD system); American Red
                                                                                                                                                         communication; myths,             Cross; MedCom--New Nursing
                                                                                                                                                         ageism, resident rights; death,   Assistant; East Central Multi-
                                                                                                                                                         dying, grieving, sprituality;     District--Brookings; Lewis &
                                                                                                                                                         mental health; normal             Clark Health Education Center,
                                                                                                                                                         physiological changes &           Yankton; LTC Network--
                                                                                                                                                         sexuality; safety; infection      Fundamentals of Care; First
                                                                                                                                                         control; nutrition; body          Step; Southeast Technical
                                                                                                                                                         mechanics; restorative            Institute
                                                                                                                                                         services; measuring &
                                                                                                                                                         recording; personal care




Training required prior to      16 hours                          40 hours classroom training      16 hours in communication and     16 hours (must      16 hours; must include             16 hours (including              16 hours                      16 introductory hours of       16 hours (including
providing direct care to a                                        plus facility orientation.       interpersonal skills; infection   include             communications and                communication and                                               classroom training in specific communictions and
resident                                                                                           control; safety and emergency     communication       interpersonal skills; infection   interpersonal skills; infection                                 areas                          interpersonal skills;
                                                                                                   procedures, including the         and                 control; safety/emergency         control; safety/emergency                                                                      infection control; safety/
                                                                                                   Heimlich maneuver; promoting      interpersonal       procedures (including             procedures, including the                                                                      emergency procedures,
                                                                                                   residents' independence;          skills; infection   Heimlich maneuver);               Heimlich maneuver; promoting                                                                   including the Heimlich
                                                                                                   respecting residents' rights;     control; safety     promoting residents'              resident's independence;                                                                       maneuver; promoting
                                                                                                   basic nursing skills; personal    and emergency       independence; promoting           respecting residents' rights)                                                                  resident's
                                                                                                   care skills; mental health and    procedures;         residents' rights                                                                                                                independence;
                                                                                                   social services of residents;     promoting                                                                                                                                            respecting residents'
                                                                                                   care of cognitively impaired      residents'                                                                                                                                           rights)
                                                                                                   residents; basic restorative      independence;
                                                                                                   services; and residents' rights   respecting rights
                                                                                                                                     of residents;
                                                                                                                                     respecting
                                                                                                                                     confidentiality




Maximum time allowed            Must be renewed every 2           Must be renewed biennially.      24 consecutive months                                                                                                     Must be renewed biennially.   There is no expiration on the   24 consecutive months;
before training program         years. Automatically removed      Must be able to document at                                                                                                                                                              certification, however aides    must provide 200 hours
and competency exam             from registry if there has been   least 400 hours of paid                                                                                                                                                                  must verify employment at       of paid services within
must be repeated for            a continuous period of 12         employment within the CNA                                                                                                                                                                least every 2 years to remain   two-year period
recertification if individual   consecutive months during         authorized duties in the two                                                                                                                                                             active on the nurse aide
has not provided nursing        which the aide has not            year preceding the expiration                                                                                                                                                            registry.
or nursing-related              provided at least 8 hours of      date.
services for monetary           nursing or health related
compensation                    services for compensation.

Deadlines to complete the 120 cumulative days - no more           Training must be completed                                         120 days to
training course and exam than 2 readmissions to a                 within 2 years prior to                                            successfully
                          training program within a 6             application for certification.                                     complete
                          month period. If lapse of time          Clinical portion must be                                           training, from
                          for readmission is greater than         completed no later than 3                                          date of
                          6 months, then trainee must re-         months following end of                                            employment; if
                          enroll as a new trainee.                classroom instruction.                                             not employed, 1
                                                                                                                                     year




                                                                                                                                                       9/29/2013                                                                                                                                                 Page 24 of 69
                                                       Summary of State CNA Training Regulations




                        Oklahoma              Oregon      Pennsylvania   Rhode Island               South Carolina   South Dakota   Tennessee   Texas               Utah
Orientation   16 hours orientation required                                                                                                             organizational structure
              specific to the employer's                                                                                                                of facility; facility
              population                                                                                                                                policies and procedures;
                                                                                                                                                        philosophy of care of
                                                                                                                                                        the facility; description
                                                                                                                                                        of the resident
                                                                                                                                                        population; employee
                                                                                                                                                        rules




                                                                                        9/29/2013                                                                             Page 25 of 69
                                                Summary of State CNA Training Regulations




                                    Vermont                        Virginia                Washington                West Virginia                     Wisconsin                       Wyoming




Type of facility covered   SNF                           SNF                         SNF                     SNF                               SNF                            SNF
Regulatory governing       Vermont Board of Nursing,     Virginia Board of Nursing   Washington State        No regulations in place for       Wisconsin Dept of Health and   follows OBRA 87--Code of
body/law                   Office of the Secretary of                                Nursing Commission,     CNA training and certification.   Family Services                Federal Regulations 42, Part
                           State                                                     Dept. of Health         West Virginia follows follows                                    483
                                                                                                             OBRA 87--Code of Federal
                                                                                                             Regulations 42, Part 483.

Authorized training                                                                  training programs
providers                                                                            approved by the state




Training program           80 hours, 50 classroom + 30   120 hours- Excludes         85 hours                120 hours                         75 hours - excluding           No fewer than 75 clock hours
requirements               clinical                      employment orientation.                                                               competency evaluation and      of training.
                                                                                                                                               provider orientation.




                                                                                                9/29/2013                                                                                                    Page 26 of 69
                                                Summary of State CNA Training Regulations

                                    Vermont                           Virginia                  Washington                       West Virginia                     Wisconsin                   Wyoming
Minimum hours of         Education programs shall         At least 40 hours clinical       35 hours classroom           Must include at least 16 hours 16 hours minimum clinical   Must include at least 16 hours
classroom and clinical   include clinical experience in   training --5 of these hours      minimum (at least 7          of supervised practical training training.                 of supervised practical training
instruction              health care facilities or        may be in a setting other than   hours in AIDS training);     (training in a laboratory or                               (training in a laboratory or
                         agencies licensed by a           a nursing home.                  50 hours clinical training   other setting in which the                                 other setting in which the
                         state's regulatory body.                                                                       trainee demonstrates                                       trainee demonstrates
                                                                                                                        knowledge while performing                                 knowledge while performing
                                                                                                                        tasks on an individual under                               tasks on an individual under
                                                                                                                        the direct supervision of a                                the direct supervision of a
                                                                                                                        registered nurse or a licensed                             registered nurse or a licensed
                                                                                                                        practical nurse).                                          practical nurse).




In-service training      Regular in-service training of                                                                                                                            Performance evaluation
required                 at least 12 hours per year                                                                                                                                required at least once every
                         based on outcomes of annual                                                                                                                               12 months with regular in-
                         performance review. Must                                                                                                                                  service education based on
                         address weaknesses as                                                                                                                                     the outcome of reviews.
                         determined by annual review                                                                                                                               -Must be sufficient to ensure
                         and any special needs of                                                                                                                                  continuing competence of
                         residents as determined by                                                                                                                                nurse aides, but no less than
                         facility staff. Must include                                                                                                                              12 hours per year.
                         care of the cognitively                                                                                                                                   -Must address areas of
                         impaired for aides providing                                                                                                                              weakness as determined by
                         those services.                                                                                                                                           performance evaluation and
                                                                                                                                                                                   may address special needs of
                                                                                                                                                                                   residents as determined by
                                                                                                                                                                                   facility staff.
                                                                                                                                                                                   -Must address care of the
                                                                                                                                                                                   cognitively impaired for nurse
                                                                                                                                                                                   aides providing those
                                                                                                                                                                                   services.




                                                                                                     9/29/2013                                                                                                        Page 27 of 69
                                               Summary of State CNA Training Regulations


                                     Vermont                         Virginia                 Washington                 West Virginia                        Wisconsin                      Wyoming
Competency exam            The Board shall approve and    Written or oral evaluation    Written or oral exam and Up to 2 years to take the exam   Written or oral and skills
                           oversee the administration,    required to include the       a clinical exam          which is a written and skills    demonstration. Given in
                           scoring and reporting of       following:                                             demonstration.                   English unless the predominant
                           exams by an approved           -Basic Nursing skills;                                                                  language where the aide will
                           testing agency.                -Personal care skills;                                                                  be working is other than
                                                          -Recognition of mental health                                                           English. An oral exam may be
                                                          and social service needs;                                                               given for individuals with
                                                          -Resident rights.                                                                       limited literacy skills.




Number of attempts         3 times                                                      4 times                                                                                    No less than 3 times.
allowed to pass exam
before training must be
repeated
Other requirements         The Nursing Assistant                                        7 hours AIDS training;                                                                     May not charge fees for
                           education program shall have                                 course must have                                                                           training or textbooks if nurse
                           statements of purpose,                                       behavioral objectives;                                                                     aide is employed by or has
                           philosophy and objectives                                    outline of information to                                                                  received an offer of
                           which are consistent with                                    be learned; learning                                                                       employment from a LTC facility
                           those of the controlling                                     activities; clinical                                                                       on the date training began; if
                           institution and with the law                                 teaching coordinated                                                                       the aide receives an offer of
                           governing the practice.                                      with classroom                                                                             employment no later than 12
                                                                                        teaching; periodic                                                                         months after completing
                                                                                        testing                                                                                    training, state pays for training
                                                                                                                                                                                   on pro rata basis




Maximum period              4 months                                                                                                                                               May not use an individual more
individual may work in a                                                                                                                                                           than 4 months on a full-time
facility before meeting                                                                                                                                                            basis unless that individual
training qualifications and                                                                                                                                                        has completed a training and
certification                                                                                                                                                                      competency evaluation
                                                                                                                                                                                   program approved by their
                                                                                                                                                                                   state. (Part time, per diem, etc.
                                                                                                                                                                                   employees must meet the
                                                                                                                                                                                   same requirements.)




                                                                                                  9/29/2013                                                                                                            Page 28 of 69
                                                  Summary of State CNA Training Regulations
                                      Vermont                       Virginia                Washington              West Virginia              Wisconsin             Wyoming
Course curriculum
specified




Training required prior to                                16 hours in the following    Demonstrated skills   16 hours in communication and                 16 hours in communication and
providing direct care to a                                areas:                       necessary.            interpersonal skills; infection               interpersonal skills; infection
resident                                                  -Communication and                                 control; safety and emergency                 control; safety and emergency
                                                          interpersonal skills;                              procedures, including the                     procedures, including the
                                                          -Infection control;                                Heimlich maneuver; promoting                  Heimlich maneuver; promoting
                                                          -Safety, emergency, Heimlich                       residents' independence;                      residents' independence;
                                                          Maneuver;                                          respecting residents' rights;                 respecting residents' rights;
                                                          -Promoting client                                  basic nursing skills; personal                basic nursing skills; personal
                                                          independence;                                      care skills; mental health and                care skills; mental health and
                                                          -Respecting client rights.                         social services of residents;                 social services of residents;
                                                                                                             care of cognitively impaired                  care of cognitively impaired
                                                                                                             residents; basic restorative                  residents; basic restorative
                                                                                                             services; and residents' rights               services; and residents' rights




Maximum time allowed          24 consecutive months -Must Renewed biennially -                               Recertification required every                24 consecutive months
before training program       be renewed every 2 years.   requirements consistent with                       2 years.
and competency exam                                       Federal law.
must be repeated for
recertification if individual
has not provided nursing
or nursing-related
services for monetary
compensation

Deadlines to complete the
training course and exam




                                                                                                9/29/2013                                                                                    Page 29 of 69
                                                                                                                    Summary of State CNA Curriculum
                                                                                                                                                                       Training Requirements




                                                                Federal Regulations




                                                                                                                                                                     District of Columbia




                                                                                                                                                                                                                                                                                                                                                                                                              New Hampshire
                                                                                                                                                                                                                                                                                                                Massachusetts




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      South Carolina
                                                                                                                                                                                                                                                                                                                                                                                                                                                                   North Carolina




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       South Dakota
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Pennsylvania

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Rhode Island
                                                                                                                                                                                                                                                                                                                                                                                                                                                                   North Dakota
                                               Corresponding




                                                                                                                                            Connecticut




                                                                                                                                                                                                                                                                                                                                                                                                                                           New Mexico
                                                                                                                                                                                                                                                                                                                                                                                                                              New Jersey
                                                                                                                                                                                                                                                                                                                                                       Mississippi




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Tennessee
                                                                                                                                                                                                                                                                                                                                           Minnesota
                                               pages in How To




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Oklahoma
                                                                                                                                                                                                                                                                                 Louisiana




                                                                                                                                                                                                                                                                                                                                                                                                                                                        New York
                                                                                                         Arkansas

                                                                                                                    California




                                                                                                                                                                                                                                                                                                                                                                                          Nebraska
                                                                                                                                                                                                                                                                      Kentucky
                                                                                                                                                          Delaware




                                                                                                                                                                                                                                                                                                     Maryland
                                                                                                                                 Colorado




                                                                                                                                                                                                                                                                                                                                Michigan




                                                                                                                                                                                                                                                                                                                                                                     Missouri




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 Vermont
                                                                Alabama




                                                                                                                                                                                                                                                                                                                                                                                Montana
                                                                                                                                                                                                      Georgia




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Virginia
                                                                                               Arizona
                                               Be a Nurse




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Oregon
                                                                                                                                                                                                                                                             Kansas




                                                                                                                                                                                                                                                                                                                                                                                                     Nevada
                                                                                                                                                                                                                                            Indiana
                                                                                                                                                                                            Florida
                                                                                      Alaska




                                                                                                                                                                                                                                 Illinois
                                                                                                                                                                                                                Hawaii




                                                                                                                                                                                                                                                                                             Maine




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Texas
                                                                                                                                                                                                                         Idaho
                                               Assistant, 4th ed.




                                                                                                                                                                                                                                                      Iowa




                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Ohio




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          Utah
                                               2008
ORIENTATION PROGRAM
 Abuse and neglect reporting                   55-56                                                                                                       X                                                                                                                                                                                                          X                                                                                  X
 Accident prevention                           chap. 10, 141-161                                                                                                                                                                                                                                                                                                                                                                                         X
 ADLs/personal care needs                      297-298, 499-500                                                                                            X
 Answering call lights                         257, 262                                                               X                                                                                                                                                                                           X                                                   X
 Ambulation                                    507-508                                                                                                     X                                                                                                                                                                                                          X
 Basic patient care                            chap. 12-22, 216-                                                      X
                                               400
 Bathing                                       298-305                                                                X                                                                                                                                                                                                                                               X
 Bedmaking (occupied and unoccupied)           256-259                                                                X                                    X                                                                                                                                                                                                          X
 Bedpan, urinal, commode and toilet            chap. 18, 339-344                                                                                                                                                                                                                                                                                                      X
 Body mechanics/transfer techniques            147-153, chap. 15,                                                     X                                    X
                                               268-292
 Bowel and bladder training                    191-192; 195-196                                                                                            X
 Care of prosthetic and orthotic devices       494-500                                                                                                     X
 Caring for the resident's environment         chap. 14, 250-267                                                      X                                    X                                                                                                                                                                                                                                                                                             X
 Communication and interpersonal skills        chap. 7, 84-99                          X                                                                   X                                                                                                                      X                               X                                                   X                                                                                                    X
 Confidentiality                               48-49                                                                                                                                                                                         X
 Daily patient routine                         18-19, chap. 12,                                                       X                                                                                                                                                                                           X
                                               216-229; chap. 28,
                                               512-522
 Detailed review of job description            24-27                                                                  X                                                                                                                      X                                                                    X                                                                                                                                      X
 Description of resident population            chap. 3, 33-45;                                            X           X                                                                                                                                                           X                               X                                                                                                                                                                                                                                                                        X
                                               chap. 23-26, 402-
                                               488
 Dressing and grooming                         chap. 16, 294-318                                                                                           X                                                                                                                                                                                                          X                                                                                  X
 Eating and hydration                          chap. 17, 320-335                                                                                           X

 Emergency equipment                           App. D, 562-563                                                                                             X
 Emergency procedures--fire and disaster       158-160                                 X                              X                                    X                                                                                 X                                    X                               X                                                   X                                                                                  X
 Employee rules                                106                                                        X           X                                    X                                                                                                                      X                                                                                                                                                                      X                                                                                                                                 X
 Ethical considerations                        19-20                                                                  X                                                                                                                      X                                                                    X
 Evacuation procedures                         158-160; App. D,                                                                                                                                                                              X                                                                                                                                                                                                           X
                                               562-563
 Facility policies and procedures              106                                                        X           X                                    X                                                                                 X                                    X                                                                                                                                                                      X                                                                                                                                 X
 Nutrition, hydrating and feeding techniques   chap. 17, 320-225                                                                                           X                                                                                                                                                                                                          X
 First aid instruction                         367                                                                                                                                                                                           X
 Gloving                                       126-128                                                                                                                                                                                                                                                                                                                X
 Grooming/bathing                              chap. 16, 294-318                                                                                           X
 Handwashing                                   125-126                                                                                                     X                                                                                                                                                                                                          X
 Heimlich Maneuver                             372                                                                    X                                                                                                                                                                                                                                               X
 Infection control                             chap. 9, 118-138                        X                                                                   X                                           X                                                                          X                                                                                   X                                                                                  X
 Legal considerations of health care           47-51; 391-393                                                         X                                                                                                                                                                                           X
 Lifting                                       147-153                                                                                                                                                                                                                                                                                                                X
 Measuring height and weight                   245-247                                                                                                     X                                                                                                                                                                                                                                                                                             X
 Measuring intake and output                   331-333                                                                                                     X




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  Needs of special populations served within the facility          chap. 23-26, 403-                                                      X                                                                                                                      X
                                                                   488
  Operating equipment - lifts, tubs, beds                          149; 287-289;302-                                                                                           X                                                                                 X
                                                                   305; 258-261
  Oral hygiene                                                     307-309                                                                                                     X                                                                                                                                                                                                          X
  Organizational structure of the facility                         6-8; 21-24                                                 X           X                                                                                                                                                           X                               X                                                                                                                                                                                                                                                                        X
  Patient comfort                                                  chap. 21, 380-388                                                      X
  Patient needs                                                    chap. 3, 32-45                                                                                                                                                                                X
  Philosophy of care                                               chap. 2, 14-30;                                            X           X                                                                                                                                                           X                               X                                                                                                                                      X                                                                                                                                 X
                                                                   chap. 5, 60-71;
                                                                   chapter 12, 216-
                                                                   229
  Plan of care for each assigned resident                          103-105, 109-111                                                                                            X
  Positioning, turning and transferring                            chap. 15, 268-292                                                      X                                    X
  Preparing residents for and serving meals                        322-329                                                                                                                                                                                                                                                                                                                X
                                                                                                                                                                                                                                                                                                      X                                                                                   X                                                                                                    X
  Psychosocial needs                                               33-43                                                                                                       X                                                                                                                                                                                                                                                                                                                                                                                             X
  Quality assessment & assurance                                   15-16; 108-110                                                                                                                                                                                                                                                                                                                                                                                            X
  Range of motion                                                  501-506                                                                                                     X
  Residents' rights                                                chap. 4, 46-59                          X                              X                                    X                                                                                 X                                    X                               X                                                   X                                                                                  X                 X
  Role of federal and state regulations in the provision of care   9; chap. 4, 46-59                                                      X
  Role of the CNA                                                  chap. 2, 14-30;                                                        X                                    X                                                                                                                                                      X                                                                                                                                      X
                                                                   chap. 28, 512-522
  Safety                                                           chap. 10, 140-152;                      X                              X                                    X                                                                                                                                                                                                          X
                                                                   chap. 20, 366-378
  Team Approach to patient care                                    6-8; 21-26                                                             X                                                                                                                                                                                           X                                                                                                                                      X
  Telephone                                                                       99                                                                                                                                                                                                                                                  X
  Toilet, perineal and catheter care                               188-200; chap. 18,                                                                                          X
                                                                   336-353
  Tour of facility and resident rooms                              251-253                                                                X                                    X                                                                                                                                                      X                                                                                                                                      X
  Use of elastic stockings, heel and ankle protectors              184-185; 360-361;                                                                                           X                                                                                                                                                                                                                                          X
                                                                   456
  Use of equipment                                                 149; 287-89;302-                                                       X
                                                                   305; etc.
  Vital Signs                                                      236-245                                                                                                     X


CURRICULUM REQUIREMENTS:
Alzheimer's Disease/Care of the Cognitively Impaired               chap. 23, 409-424X          X           X        X                                             X            X             X                             X         X        X                                   X                                                                  X          X            X            X                                                         X            X           X          X XX             X                    X                              X               X             X X                 X
Behavior - appropriate responses                                   414-421          X          X                                                                                             X                             X                  X                  X        X       X                                                                  X          X            X                                                      X               X            X           X          X X                                   X              X                               X             X                   X                X
Behavior - understanding                                           410-411          X          X                                                                                             X                             X                  X                                   X                               X                                  X          X            X                                                                      X            X           X          X X                                                  X                               X             X                   X                X
Care for the confused patient                                      412-421                                                                                                                                                                                                        X                               X                   X                                                                                   X                                                                X
Care of the cognitively impaired                                   412-421          X          X                                                                                             X                                                X                                   X                               X                   X              X                       X                                                                      X            X           X          X X                                                                                                X                   X
Cognitive Changes                                                  409-412                                                                                                                                                                            X                           X                                                                                                                                                                                          X             X                                                                 X               X
Communicating with cognitively impaired                            415-416          X          X                                                                                             X                             X                  X                           X       X                               X                   X              X          X            X                                                                      X            X           X          X X                         X                        X                                             X                   X                X




                                                                                                                                                                                                                                              9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 31 of69
                                                                                                                                              Summary of State CNA Curriculum




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                                                                       2008
Coping mechanisms used by the resident to compensate for               417-421                                                                                                                                                                              X                           X                                                                                                                                                                                          X                   X
irreversible cognitive decline.
Define dementia - reversible/non-reversible                            410-411                                                                                                                                                                              X                           X                               X                                                                                                                                                                              X
Dementia - cause, course and symptoms of impairment                    410-12                                                                                                                                                                                                           X                               X                                                                                                                                                          X                   X                                                           X                                                 X
Difference between normal aging and cognitive dysfunction              198-200; 410-412                                                                                                                                                                     X                           X                               X                   X                                                                                                                                      X
disease process.
Economic impact of Alzheimer disease and related disorders
Environmental impact and stress reduction                              417-421                                                                                                                                                                                                          X
Feeding and fluid intake problems with dementia                        412-413; 421-422                                                                                                                                                                                                 X                                                                                                                                                                                          X
Health impact of Alzheimer's disease and related disorders             198-200; 410-411                                                                                                                                                                     X                           X                               X                                                                                                                                                          X
How dementias are diagnosed                                                                                                                                                                                                                                 X
Importance of observation and ways to monitor behavior and safety      415-424                                                                                                                                                                              X                           X                                                                                                                                                                                                              X                  X
Importance of touch and companionship                                  27; 87-89; 416;                                                                                                                                                                      X                           X                                                                                                                                                                                                                                                                                          X
                                                                       424
Inter-disciplinary nature of treatment in care                         424                                                                                                                                                                                  X                           X
Intervention strategies for dementia residents                         412-424                                                                                                                                                   X                                                      X                                                                                                                                                                                                              X
Language and communication changes                                     411; 415-416                                                                                                                                                                         X                           X                                                   X                                                                                                                                                          X
Loneliness                                                             411                                                                                                                                                                                                              X                                                                                                                                                                                                              X                                                           X
Memory Loss                                                            409-415                                                                                                                                                                              X                           X                                                                                                                                                                                                              X
Methods for reducing the effects of cognitive impairment               414-424                                                                                                                                                   X                                                      X                                                                             X                                                                                                                                X                                                                           X
Mood and behavior disturbances for residents with a progressive        408-412; 417-419                                                                                                                                                                     X                           X                                                   X                                                              X
dementing disorder
Unique needs and behaviors of individuals with dementia                409-424              X X                                                 X                                                  X                             X                  X                  X        X       X        X                      X                   X              X          X            X                       X                                                           X           X          X                                                                                    X             X                                    X
Needs of persons with developmental and mental disorders - mental      405-424                                                                  X                                                                                                                                       X                               X                   X                                                              X                                                                       X                   X                                           X
retardation, Alzheimer's disease, cerebral palsy, epilepsy, dementia
and mental illness
Nutrition: cognitive and physiological changes that affect nutrition   421-422                                                                                                                                                                              X                           X
and feeding patterns.
Perceptual dysfunction                                                 421                                                                                                                                                                                  X                           X                                                                                                                                                                                                              X
Physical changes & their effects                                       199-200; 411                                                                                                                                                                         X                           X                               X                                                                                                                                                                              X                                                           X
Primary signs and symptoms of Alzheimer's disease and related          411-412; 417-421                                                                                                                                                                     X                           X                               X                                                                                                                                                                              X
disorders
Psychological, social, and recreational needs                          32-43; 412-416                                                           X                                                                                                                                       X                                                                                                                                                                                                              X
Purpose and philosophy of a facility-based Alzheimer's Unit            4; 408-409; 412                                                                                                                                           X
Reality orientation                                                    418-421                                                                                                                                                                                                          X                                                                                                                                                                                                                                                                          X
Reducing the effects of cognitive impairment                           412-424              X X                                                                                                    X                                                X                  X        X       X                                                                  X                       X                                                                      X            X           X          X        X                                           X                                             X                   X                X
Sensory impairments                                                    204-208                                                                                                                                                                              X                           X                               X                                                                                  X                                                                       X
Social impact of Alzheimer disease and related disorders.              411; 414-417                                                                                                                                                                         X                           X                                                                                                                                                                                                              X
Techniques for enhancing communication                                 414-417                                                                                                                                                                              X          X        X       X                               X                   X                                                                                                                                                          X
Techniques for responding to wandering and confusion                   419-420                                                                                                                                                                                                          X                                                   X
Terminology used to describe dementia                                  402; 411                                                                                                                                                                             X                           X                               X
Use of diversional activities                                          417                                                                                                                                                                                                              X
Wandering                                                              419-420                                                                                                                                                                                                          X                                                   X                                                                                                                                      X

Anatomy/Physiology:                                                    chap. 11, 164-212
Anatomy of body discharge and elimination                              188-198                                                                  X                                                                                                           X                           X                               X       X                                                                                                                                                  X                   X                                                                           X
Anatomy of digestion                                                   188-198                                                                                                                                                                              X                           X                               X                                                                                                                                                                              X




                                                                                                                                                                                                                                                    9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 32 of69
                                                                                                                                   Summary of State CNA Curriculum




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Anatomy of the reproductive system                            208-211                                                                                                                                                                            X                           X                               X
Basic anatomy and physiology                                  chap. 11, 164-212                                                      X                                    X                                                                      X                           X                               X                                                                                  X        AC                                                                                                    X                        X

Basic Nursing Skills:                                         chap. 9, 10, 11, X X                    X        X                                             X                          X                                       X        X                                                       X                                              X                       X            X                                                         X            X           X          X X              X                    X                                              X             X X                 X X
                                                              12-27, etc.
Abnormal changes in body function                             chap. 11, 164-212 X X                                                                                                     X                             X                  X                  X        X       X                               X                                  X          X            X                                                      X               X            X           X          X                                                    X               X               X             X                                    X
Applying cold/heat applications                               386; 439-441                                                                                                X                                                                      X                           X                               X                                                                                           AC                                                                                                                             X
Applying non-sterile dressings/compresses                     362-363; 439-441                                                       X                                    X                                                                                                  X                               X                                                                                                                                                                                                                          X               X
Applying warm or cold-moist or dry K-pad ice pack             439-441                                                                                                                                                                                                        X                               X                                                                                                       X
Bed and side rails adjusting                                  55; 154-155; 272                                                                                                                                                                                               X        X                      X                   X                                                                        X
Care of resident with oxygen                                  181; 432-439                                                                                                                                                                                                   X        X                      X                                                                                                       X                                                  X                                      X
Patient care plans (admission, transfer, discharge)           108-11; 251-53;                                                        X                                                                                                           X                           X        X                      X                                                                                                                                                          X                   X       X          X                        X                               X
                                                              263-65                                                                                                                                                                                                                                                                                                                                                 X
Clinical care of the aged and disabled                        chap. 11, 164-212,                                                                                                                                                                                             X                               X                                                                                                                                                                                                                                                                                                             X
                                                              etc.
Common cold                                                   178-179                                                                                                                                                 X                                                                                      X
Disease process: recognizing abnormal signs and symptoms of   chap. 11, 164-212                                                                  X                        X                                           X                          X                           X                   X           X                   X                                                                       AC                                                                                         X          X                                                                                          X
common diseases
Fecal impaction                                               189                                                                                                                                                     X                                                      X                               X                                                                                                                                                                              X
Hypoglycemia and hyperglycemia                                430                                                                                                                                                     X                                                      X                               X
Indentifying nursing and medical equipment                    149; 287-89;302-                                                                                                                                                                                                                               X                                                                                                                 X
                                                              305; etc.
Intravenous fluids                                            227; 443-445                                                                                                                                                                                                   X                                                                                                                                       X
Introduction to pharmacology                                  10                                                                                                                                                                                                                                                                                                                                         AC
Measuring and recording height and weight                     245-247          X X                    X                              X           X                                      X                             X                  X       X          X        X       X        X          X           X       X           X              X          X            X            X                    X          X                         X            X           X          X        X                  X                        X                               X             X                   X                X
Medications/Drugs:                                            50; 383-84
    Administering oral and external                           50; 381-384                                                                                                                                                                                                    X                               X                                                                                           AC
    Resource materials                                                                                                                                                                                                                                                                                                                                                                                   AC
    Actions and interactions                                                                                                                                                                                                                                                                                                                                                                             AC
    Effect on the elderly                                     384                                                                                                                                                                                                                                                                                                                                        AC
    Remind resident to take medications                       381                                                                                                                                                                                                                                                                                                                                                                                                                                                                       X
    State and federal regulations                                                                                                                                                                                                                                                                                                                                                                        AC
Minimum Data Set                                              108-109; 230                                                                                                                                                                                                                                                                                                                                                                                                                          X
Monitoring Body Functions                                     chap. 11, 164-212                       X                                                                                                                                                                      X                               X                                                                                  X                                                                                                                                                                       X

Nausea, vomiting, and diarrhea                                120; 189; 191;                                                                                                                                          X                                                      X                               X                                                                                                                                                          X                                                                               X
                                                              330; 344; 384; 462
Pain management                                               chap. 21, 380-387                                                                                                                                                                                                                                                                                                                                                                                         X
Recognizing and reporting changes in residents                chap. 8, 102-115
      Blue color in lips                                      178; 180; 183;                                                                                                                                                                                                                                                                                                                                                                                            X                                      X
                                                              185
      Chills                                                  182-85; 202                                                                                                                                                                                                                                                                                                                                                                                               X                                      X
      Coughs                                                  121-122; 178-180;                                                                                                                                                                                                                                                                                                                                                                                         X                                      X
                                                              436; 457;
      Drowsiness                                              202-203; 385                                                                                                                                                                                                                                                                                                                                                                                              X
      Excessive thirst                                        202-203; 330-331                                                                                                                                                                                                                                                                                                                                                                                          X                                      X
      Pain in chest or abdomen                                182; 186-187; 368-                                                                                                                                                                                                                                                                                                                                                                                        X                                      X
                                                              369




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Ohio




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Utah
                                                                    2008
      Pus                                                           169                                                                                                                                                                                                            X                                                                                                                                                                                          X                                      X
      Rapid respirations                                            177-179; 241-242                                                                                                                                                                                                                                                                                                                                                                                          X                                      X
      Shortness of breath                                           177-180; 241-242                                                                                                                                                                                                                                                                                                                                                                                          X                                      X
      Sweating                                                      169                                                                                                                                                                                                                                                                                                                                                                                                       X
Shunts used for dialysis                                            441-443; 515                                                                                                                                                                                                                                   X
Specimens: Non-invasive collection and testing of physical          179; 344-349                            X                              X                                                                                                           X                           X                                                                                                                                                                                                                                 X                        X                               X
specimens                                                                                                                                                                                                                                                                                                                                                                                                                  X
   Sputum specimens                                                 179                                                                    X                                                                                                                                       X        X                                                                                                                              X                                                                                         X                        X
   Stool specimens                                                  349                                                                    X                                                                                                                                       X        X                      X                                                                                                       X                                                                                         X                        X                               X
   Urine specimens                                                  345-348                                                                X                                                                                                                                       X        X                      X                                                                                                       X                                                  X                                      X                        X                               X
Topical ointments to skin surfaces                                  173; 298; 300; 357                                                     X                                                                                                                                       X                               X                                                                                                       X                                                                                                                  X
Upper respiratory infections                                        179-180                                                                                                                                                 X                                                                                      X                   X
Vital Signs:                                                        236-244                                                                                                                                                                                                                                                                                                                                                                                                                       X
    Changes/abnormalities                                           170-171; 236; 240-                                                     X                                                                                X                          X                           X                               X                                                                                                                                                                                                                                          X               X
                                                                    243
   Taking and recording                                             236-244          X X                    X                              X           X                        X             X                             X                  X       X          X        X       X        X          X           X                   X              X          X            X                                            X                         X            X           X          X        X                  X                                        X               X             X                   X
   Blood pressure                                                   241-244                                                                X                                                                                X                          X          X                X        X                      X       X           X              X                                               X                              X                                                            X                  X                        X
   Temperature, pulse, respiration                                  236-241                                                                X                                                                                X                          X          X                X        X                      X       X           X              X                                               X                    X         X                                        X                   X                  X                        X               X

Basic Restorative Care:                                             chap. 27, 490-508X X                                                                                                      X                                       X        X                                   X                                                                  X                       X                       X                                              X            X           X          X X                                   X                                              X             X X                 X X              X

Activities of daily living (ADLs)                                   297-298, 499-500                        X                                                                                                                                          X                                                                   X           X                                                                                                                                                                             X                        X
Ambulation                                                          507-508                                 X                              X                                                                                X                                              X       X                   X           X                                             X                                    X                              X                                        X                   X                  X                        X                               X
Ambulation in eating and dressing                                   314-315; 324-325;                                                                  X                        X                                           X                          X                           X                   X                   X                                                                                    X                    X                                                                               X
                                                                    507-508
Antiembolus stockings                                               184-185; 456                                                                                                X                                                                                                  X                                       X                                                                                               X                                                                                         X                        X
Assist resident to move to head of bed                              272-273                                                                                                                                                                                       X                X                               X                                                                                                       X
Assist to bathroom                                                  286; 339-343                                                                                                                                                                                  X                X                               X                   X                                                                                   X
Assist to chair                                                     282-285                                                                                                                                                                                       X                X        X                      X                   X
Assist with standing/walking                                        507-508                                                                                                                                                                                       X                X        X                      X       X
Assisting with coughing                                             436; 457                                                                                                                                                                                                                                                                                                                                                                                                                                         X
Assistive devices (in transferring, ambulation, eating, dressing)   329; 494-496      X         X                                          X                                                  X                             X                  X       X          X        X       X        X                      X                                  X          X            X                                            X                         X            X           X          X        X                  X                        X                               X             X                   X                X
Back rubs                                                           300; 386                                                                                                                                                X                                     X                X        X                      X                                  X                                                         X          X
Basic preventative care and procedures                              chap. 9, 118-137;                                                                                                                                                                                              X                                                                                                       X
                                                                    chap. 10, 140-161;
                                                                    chap. 19, 354-364
Basic restorative care                                              chap. 27, 490-508 X         X                    X                                             X                          X                                       X        X                                   X                   X           X       X                          X                       X            X                                                                      X           X          X                X                                                                                 X
Body alignment/positioning                                          chap. 15, 268-291 X         X                                                                                             X                                                X                                   X                               X                   X              X                       X                       X                                                           X           X          X        X                  X                        X               X               X             X                   X
Bowel and bladder training/management                               191-192; 195-196; X         X                                          X           X                        X             X                             X                  X       X          X        X       X        X          X                               X              X          X            X                       X         X                    X               X            X           X          X        X                  X                        X               X               X             X                   X                X
                                                                    339                                                                                                                                                                                                                                                                                                                                                    X
Braces, applying                                                    494-500                                                                                                                                                                                                        X                               X                                                                                                                                                                                                 X
Choosing appropriate clothing                                       316                                                                                                                                                     X                                                      X
Complications of inactivity                                         174-87; 270; 501-                                                      X                                                                                                                                       X
                                                                    506
Decision making                                                     50-51; 218                              X                                                                                                                                                                      X




                                                                                                                                                                                                                                               9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 34 of69
                                                                                                                               Summary of State CNA Curriculum




                                                                           Federal Regulations




                                                                                                                                                                                District of Columbia
                                                                                                                                                                                  Training Requirements




                                                                                                                                                                                                                                                                                                                                                                                                                         New Hampshire
                                                                                                                                                                                                                                                                                                                           Massachusetts




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                                                                                                                                                                                                                                                                 Iowa




                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Ohio




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Utah
                                                           2008
Difference in approaching ADLs                             296-298; 421-424;                                                                                                                                                                 X
                                                           499-500
Digital stimulation                                        387; 505                                                                                                                                                                                                                                      X                                                                                                       X
Exercise programs                                          186; 362-68; 404                                                                                                                                                                                              X                                                                                                                                                                                          X
Extremity elevation                                        283-284; 498; 360                                                                                                                                                                                             X                                                                                                                                                                                                                                 X
Footboards, using                                          187                                                                                                                                                                                                           X                               X                   X                                                                                                                                                                             X
Gait belts (guard belt)                                    278                                                                                                                                                    X                                                      X        X                      X                                                                                                       X
Help clients using hearing aids and glasses                205-207                                                                                                                                                                                                       X                                                   X                                                                                                                                      X                   X                  X                                                        X
Impact of Immobility & measures to overcome                174-87; 270; 501-                                                                                                                                                                                             X                                                                                                                                                                                          X                   X
                                                           506
Lifting                                                    147-153; chap. 15,                                                                                                                                                                                            X                               X                   X                                                                                                                                                          X                  X                                        X
                                                           268-291
Maintaining range of motion                                501-506           X X                                                 X           X                        X             X                             X                  X       X          X        X       X        X          X           X       X           X              X          X            X                       X         X                    X               X            X           X          X        X                  X                        X                               X             X                   X                X
Manipulating adaptive devices or special equipment         329; 494-496                                                                                                                                           X                                                      X                               X                                                                                                                 X
Mechanical lifts                                           283; 287-289                                                                                                                                           X                                                      X        X                      X                   X                                                                                                                                      X                   X                                           X
Mobility                                                   269-271; 501-508                                                      X                                                                                                                                       X                               X       X           X                                                                                                                                      X                           X                                                   X               X
Orthodic devices (care and use)                            496-498           X X                                                                                                    X                                                X                           X       X                               X                                  X          X            X                       X                                              X            X           X          X                           X                        X                               X             X                   X                X
Passive range-of-motion exercises                          501-506                                                                                                                                                                                                       X                               X                   X                                                              X        AC                                                             X                                      X                                                        X                                 X
Position and comfort measures:                             chap. 15, 268-291                                                                                                                                                                                                                                                                                                                                                                                                            X
   Positioning (bed and chair)                             272-289           X X                                                 X                                                  X                             X                  X                                   X                               X       X           X              X          X            X                       X                              X               X            X           X          X                           X                                                        X             X                   X                X
   Positioning devices and types of positions              chap. 15, 268-291                                                                                                                                      X                                              X       X                               X
   Supine Position                                         273-277; 280                                                                                                                                                                                 X                X                               X                   X                                                                                   X
   Side-lying positioning                                  275; 278; 281                                                                                                                                                                     X                           X                               X                   X              X                                                                    X
   Fowler's Position                                       277; 279                                                                                                                                                                                     X                X                                                                                                                                       X
   Lateral Position                                        278; 281                                                                                                                                                                                     X                X
   Semi-Fowler's Position                                  277                                                                                                                                                                                          X                X
   Sims position                                                                                                                                                                                                                                                         X                                                                                                                                       X
   Sit On Edge of Bed                                      276-277; 282; 285-                                                                                                                                                                           X
                                                           286
Pressure ulcers                                            173; chap. 19, 354-                                                                                                                                                                                                                                                                                                                                                                                                          X
                                                           365
Pressure ulcers - development                              173; 358-359                                                                                                                                                                                                                                                                                                                                                                                                                 X
Preventative and rehabilitation                            chap. 27, 490-508                      X                                                                                                                                          X                           X                               X                                                                                                                                                          X
Preventing contractures                                    175                                                                                                                                                                                                           X                                                                                                                                                                                          X
Preventing decubitus ulcers                                173; chap. 19, 354-                                                   X                                    X                                                                      X                           X        X                                                                                                                                                                                 X                   X                  X                                                        X                                                  X
                                                           365
Prosthetic devices (care and use)                          496-499           X X                                                 X           X                        X             X                             X                  X                           X       X                   X           X                                  X          X            X                       X                    X                         X            X           X          X        X                  X                        X                               X             X                   X                X
Range-of-motion exercises                                  501-506                                                                                                                                                                                                       X                                                                                                                                                                                          X
Reinforcing breathing exercises                            404; 435-436; 457                                                                                                                                                                                                                                                                                                                                                                                                                               X
Special care for clients with tubes or special equipment   181; 271; 350-351;                                                    X                                                                                                                                       X                                                                                                                                                                                                                                 X
                                                           433-445
Stretchers/Transfer boards                                 149; 279; 290                                                                                                                                                                     X                           X        X                      X                                                                                                       X
Training the resident in self-care                         26; 218; 412-413; X X                                                                                                    X                             X                  X                  X        X       X                                                                  X                       X                                                                      X            X           X          X        X                                           X                               X             X                   X                X
                                                           499-500
Transferring a patient                                     chap. 15, 268-291 X X                  X                              X           X                        X             X                             X                  X       X          X        X       X        X          X           X       X           X              X          X            X                       X         X          X         X               X            X           X          X        X                  X                        X               X               X             X                   X                X
      Bed to wheelchair                                    282; 285                                                                                                                                                                                                      X                                                   X                                                                                                                                                          X
      Bed to commode                                       282; 286                                                                                                                                                                                                      X                                                   X



                                                                                                                                                                                                                                     9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 35 of69
                                                                                                                                          Summary of State CNA Curriculum




                                                                                      Federal Regulations




                                                                                                                                                                                           District of Columbia
                                                                                                                                                                                             Training Requirements




                                                                                                                                                                                                                                                                                                                                                                                                                                    New Hampshire
                                                                                                                                                                                                                                                                                                                                      Massachusetts




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            South Carolina
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         North Carolina




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             South Dakota
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Rhode Island
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                                                                                                                                                                                                                                                                                                                                                                             Mississippi




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Utah
                                                                   2008
      Chair to bed                                                 286; 289                                                                                                                                                                                                         X                                                   X
      Wheelchair to tub                                                                                                                                                                                                                                                                                                                 X
                                                                   chap. 11, 164-212,
Treatments                                                         etc.                                                                                                                                                                                                             X                               X       X                                                                                                                                                  X
Turning                                                            275; 281          X X                                                    X                                                  X                                                X                                   X                               X                                  X                       X                                            X         X               X            X           X          X        X                  X                        X                               X             X                   X                X
Turning and positioning in bed & chair                             chap. 15, 268-291 X X                                                                X                        X             X                             X                  X       X          X        X       X        X          X           X       X                          X                       X                                 X                                    X            X           X          X                           X                                                        X             X                   X                X
Use of eggcrate mattress, lambskin pads                            172; 360-361                                                                                                                                              X                                                      X                                                                                                                                                                                          X                   X                                           X               X
Using anti-pressure devices                                        172; 360-361                                                                                                                                                                                                     X                               X                                                                                                                                                          X                   X                  X                                        X               X
Wheelchairs/walkers/canes                                          279; 282-286; ;                                                                                                                                           X                                                      X                               X                   X                                                                                   X                                                  X                   X                  X
                                                                   492-496

Care of Resident's Environment (Room)                              chap. 14, 250-266X X                      X        X                                 X                                      X                                                X                  X        X       X                   X           X       X           X              X          X            X                       X                              X               X            X           X          X        X                                           X                               X             X                   X                X
Adaptive devices                                                   329; 494-496; 499-                                                                                                                                        X                                                                                                                                                                                                        X                                        X                                      X                                                        X
                                                                   500
Appropriate maintenance of environment to minimize the need for    53; 155-156      X X                                                                 X                        X             X                                                X                                   X                   X                                              X                       X                                                                                   X           X          X        X                                                                                         X
physical & chemical restraints
Arrange furniture & equipment for resident's convenience to keep   153-156; 219;; 257                                                                                            X                                                                                                  X                                                   X                                                                                                                                                          X
environment safe
Bedmaking procedures (occupied/unoccupied)                         256-261                                                                  X                                    X                                           X                          X          X                X        X          X           X       X           X              X                                    X          X         X          X                                                  X                   X                  X                        X
Call lights - use and position                                     225-226; 257; 262                                                                                                                                         X                                                      X                               X                   X                                                                        X          X                                                                      X
Care of personal articles                                          249; 251-52                                                                                                                                               X                                                      X                                                                                                                                                                                          X
Caring for resident's environment                                  252-257; 148-157 X X                                                                                                        X                                                X                                   X                               X                   X              X                       X                       X                                              X            X           X          X        X                  X                                                                      X
Difference between clean and dirty                                 126; 135-137                                                                                                                                                                         X                                                                               X
General cleaning                                                   135-137; 265                                                                                                                                              X                                                                                                                                                                         X                                                                                                                                       X
Housekeeping                                                       135-137; 252; 254;                                                                                                                                                                                               X                                                                                                                  X                    X         X                                                                                                        X
                                                                   257
Identify need for a clean and comfortable environment              252-53; 257; 263                                                                                              X                                                                      X                           X                                                                                                                                                                                                              X                                           X                               X
Lighting, adjust                                                   91; 154; 252; 385                                                                                                                                                                                                                                                                                                                                                                                                               X
Noise reduction                                                    257; 385                                                                                                                                                                                                         X                                                                                                                                                                                                              X                                                           X
Preparing soiled linen                                             142; 258-61; 265                                                                                              X                                                                                                                                                                                                                     X         X                                                                                                    X
Provide a safe, clean, environment                                 153-158; 254-57;                                                                                              X                                           X                                                      X        X                                                                                                         X                              X                                                            X       X          X                                                        X
                                                                   265
Recognizing and responding to unsafe environment conditions        chap. 10, 140-161                                                                                                                                                                                                X                                                   X                                                                                             X
Reporting evidence of pests                                                                                                                                                      X
Room checks prior to client occupancy                              252-254; 263                                                                                                                                                                         X
Special clothing                                                   255; 316                                                                                                                                                                                                                                                                                                                                                           X                                        X
Spills of blood/bodily fluids, handling                            132-137; 141-146                                                                                                                                                                                                                                                                                                                                                                                                                                                            X
Temperature, keeping the correct                                   257                                                                                                                                                                                                                                                                                                                                                                                                                             X

Communication/Interpersonal Skills:                                chap. 7, 84-100 X X                                X                                 X                        X             X                             X                  X                                   X                   X           X       X           X              X                       X            X          X                              X               X            X           X          X                           X                        X               X               X             X X                 X X              X
Appropriate communication                                          61-68; 78-79;                                                            X                                                                                                           X                           X                               X       X                                                                                                                                                                                         X
                                                                   chapt. 7, 84-100;
                                                                   217; 451-452; 416
Positive Attitude                                                  15-28; 76-77; 526-                                                                                                                                                                                                                                                                                                                                                                                                              X
                                                                   527; 540
Assertive vs. agressive responses                                  95-98; 541                                                                                                                                                                                                       X
Attitudes towards illness and health care                          15-17; 28; 525-                                                          X
                                                                   527


                                                                                                                                                                                                                                                9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 36 of69
                                                                                                                                           Summary of State CNA Curriculum
                                                                                                                                                                                                  Training Requirements




                                                                                       Federal Regulations




                                                                                                                                                                                                District of Columbia




                                                                                                                                                                                                                                                                                                                                                                                                                                         New Hampshire
                                                                                                                                                                                                                                                                                                                                           Massachusetts




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 South Carolina
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              North Carolina




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  South Dakota
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                                                                     2008
Barriers to communication                                            90-93; 415-416                                                                                                                                                                                                      X                               X                                                                                                                                                                              X                  X                                        X
Communicating with respect and dignity                               61-68                                                                                                                                                                                                               X                                                                                                                                                 X                                                                                                                                        X
Communicating with the angry or violent client.                      90-95                                                                                                                                                                                                               X                                                                                                                                                                                                              X                  X
Communicating with the visually/hearing impaired and unconscious     91-92; 205-206                                                                                                                                               X                                                      X                               X                                                                                                                                                                              X                  X                                                        X
patient
Communication techniques/formats                                     chap. 7, 84-100                                                                                                                                              X                          X                           X                               X                                                                                            X                    X
Communication with resident, family, staff                           22-23; 78-81; 86-                                                       X                                                                                                                                           X        X                                                                                                         X                                                                       X                   X                  X
                                                                     99
Conflict resolution                                                  95-98; 540-541                                                                                                                                               X                                                                                                                                                                                                                                                                                        X                                                                                                           X
Courtesy                                                             99                                                                                                                                                           X                                                      X                               X                   X                                                                                                                                                          X
Defense mechanisms                                                   95-96                                                                   X                                                                                                                                           X                                                                                                                                                                                                              X
English, knowledge of (reading, writing, speaking, understanding)    86-87                                                                                                                                                                                                                                               X
Explaining procedures before they are done                           221-224; 450; 463;                                                                                                                                                                                                  X                               X                   X
                                                                     493
Importance of listening                                              88-89; 91; 102;                                                                                                  X                                                                      X                           X                                                   X                                                                                                                                                          X
                                                                     394; 449-450
Interpersonal skills                                                 chap. 7, 84-100                                                         X                                                                                                                                   X       X                                       X                                                                                                                                                                      X       X
Introduction to the resident                                         89; 253; 409                                                                                                                                                 X                                                      X                                                                                                                                                                                                              X
Knowledge of communication modifications                             89-99                                    X        X                                                                                                                                                                 X                               X
Importance of confidentiality                                        48-49; 111                                                              X                                                                                                               X                           X        X                      X                                                                                                                                                          X                   X                  X
Psychosocial Needs                                                   33-34; 134                               X                                                                                                                   X                                                      X                                                    x                                                                                            X                                        X                                                                                               X                                        X
Sensitivity Training                                                                                                                                                                  X                                                                                                                                  X                                                                                                                                                                              X                                           X
Sociocultural factors                                                18-19; 396                                                              X                                                                                                                                           X                                                                                                                                                                                          X
Telephone skills                                                     99                                                                                                                                                           X                                                      X                                                                                                                                                                                                              X
Verbal and nonverbal communications                                  86-88                                    X                                                                       X                                                                      X                           X                               X                   X                                                                                   X                                                                      X                  X                                        X

Competency in the role of the CNA:                                   chap. 2, 14-29;
                                                                     chap. 30, 536-543
Acceptable and non-acceptable touching                               27; 55-57; 87-88                                                                                                                                                                                                    X                                                                                                                                                                                                              X
Adapting theoretical content and skills to the facility's specific   chap. 23, 402-424                                                                             X
population
Authorized duties                                                    23-27                                                                                                                                                                                                               X                               X                                                                                                                                                                                                 X
Awareness of empathy and compassion                                  17; chap. 3, 32-44;                                                                                                                                                                     X                           X                               X                                                                                                                                                                              X
                                                                     chap. 5, 60-70
Balancing appropriate care with need for protection for self and     94-95; 417-418                                                                                                                                                                                                      X                                                   X
others in working with combative clients
CNA as a member of the health care team                             6-8; 21-23; 513-                          X        X                                                              X                                           X                          X                           X                   X           X       X           X                                                                                                                                                          X                  X                        X                               X                                       X
                                                                    514
Prioritizing tasks                                                  219; 515                                                                                                                                                                                                                                                                                                                                                                                                                            X
Differentiate between ethical and unethical behavior on the job.    19-20                                                                                                             X                                                                                                  X                                       X                                                                                                                                                                              X                                   X
Form a relationship, communicate, and interact competently on a     6-8; chap. 2, 14-                                            X                                                                                                                                                       X
one-to-one basis with the resident as part of the team implementing 28; chap. 28, 512-
resident care objectives                                            521
Ethical implications/standards                                      19-20; 513-514                            X                              X                                                                                                               X                           X                                       X                                                               X                                         X                                                                               X                                                        X
Functions of health care facilities                                 3-4                                                                                                                                                                                      X                           X                               X




                                                                                                                                                                                                                                                     9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 37 of69
                                                                                                                                              Summary of State CNA Curriculum




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                                                                       2008
Goals of LTC facility                                                  3-6; 15-17; 492-                                                                                                                                                                                                 X
                                                                       493
Handling family questions                                              76-81                                                                                                                                                     X                                                                                                                                                                                                                                                                     X
Holistic care through lifespan                                         3-6; 15-18; chap.                                                                                                                                                                                                                                                                                                                                                  X
                                                                       3, 32-44; chap. 29,
                                                                       524-532
Home health agencies and the health care profession                                                                                                                                                                                                         X                           X                               X
How to interact to avoid behavior which can be interpreted as          55                                                                                                                                                                                                               X                                                                                                                                                                                                              X
abuse or neglect
Identify the chain of command in the organizational structure of the   21-22                                                                                                         X                                                                      X                           X                               X                                                                                                                                                                              X
health care facility
Identifying how and when to seek guidance                              21-23                                                                                                                                                                                                            X
Importance of consistency in approach, focusing on ability, task       493; 416-417                                                                                                                                                                         X
breakdown techniques, cuing and distraction techniques
Importance of good personal hygiene and health                         27-28; 124-126;                                                                                                                                                                                                  X        X                      X                                                                                                                 X                                                            X
                                                                       chap. 29, 524-532
Job description                                                        24-27                                                                                                                                                                                                            X                                                   X
Perform uncomplicated nursing precedures and to assist licensed        chap. 11, 164-212;                                           X                                                                                                                                                   X                                                                                                                                                                                                                                                                                          X
practical nurses or registered nurses in direct resident care          chap. 24, 428-446,
                                                                       etc.
Policies and procedures, knowledge of                                  50; 56-57; 106;                                                                                                                                                                                                  X                               X                                                                                                                                                                              X                                           X
                                                                       113
Procedure if nursing assistant is investigated for abuse               56-57                                                                                                                                                                                                                                                                                                                                                                                                                           X
Professional manner, dress and grooming                                20; 514                                                                  X                                    X                                           X                          X                           X                               X                                                                                                                                                                              X                  X
Recognize components of working relationships                          21-23                                                                                                                                                                                                            X                               X                                                                                                                                                                              X                  X
Recognize importance of punctuality and commitment to the job          22; 514                                                                                                       X                                                                      X                           X                               X                                                                                                                                                                              X
Recognize responsibility of staff to agressive/wandering residents     94-95; 417-421                                                                                                X                                                                                                  X
Recognizing how aging affects memory, sexuality, mood, behavior        198-200; 410-424                                                                                              X                                                                                                  X                                                                                                                                                                                          X                   X                                                           X               X
and wandering
Role of ombudsman                                                      57                                                                                                                                                                                                                                                                   X                                                                                                                                                          X
Role of the CNA in the long-term care facility                         chap. 2, 14-28                                                                                                X                                                                      X                           X                               X       X                                                                                               X         X                                                                                                        X
Role of the multidisciplinary health care team and integration of      6-8; 21-23; 513-                                                                                                                                                                     X                           X                               X                                                                                                                                                                                      X                                   X               X               X
services for the total care of the patient                             514
Self attitude and behavior management                                  15-28; 76-77;                                      X                                                          X                                                                      X          X        X               XX          X           X                                                                                                                                                                                                                          X
                                                                       chap. 12, 217-228;
                                                                       526-527; 540
State licensure and certification requirements                         537                                                                      X                                                                                                                                       X                               X                                                                                                                                                                              X                  X
State survey process                                                   Appendix F, 570-                                                                                                                                                                                                                                                     X                                                                                                                                                          X                  X
                                                                       571
Stress factors in caring for persons with irreversible cognitive       27-28; 409-415;                                                                                                                                                                      X
decline                                                                526
Stress management related to performance of duties                     27-28; 526                                                                                                                                                                                                                                       X                   X
Time management                                                        219; 515-521                                                                                                                                                                                                                                                         X                                                                                                                                                          X
Title 22, division 5, California Code of Regulations overview                                                                                   X
Types of LTC facilities                                                4                                                                                                                                                                                                                X
Unbecoming conduct for a CNA                                           56-57                                                                                                                                                                                                            X                               X                                                                                                                                                                                                 X
Understanding the patient-family relationship                          chap. 6, 72-81                                                                                                                                                                       X                                                           X



                                                                                                                                                                                                                                                    9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 38 of69
                                                                                                                                        Summary of State CNA Curriculum




                                                                                    Federal Regulations




                                                                                                                                                                                         District of Columbia
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Understanding the role of LTC advocates, investigators, and        57; Appendix F,                                                                                             X                                                                                                                                                      X                                                                                                                                                          X
surveyors                                                          570-571
Uniqueness and rewards of caring for the geriatric patient         81; 538-540                                                                                                                                                                        X                                                           X
When allegations are substantiated against a nursing assistant     56-57                                                                                                                                                                                                                                                                                                                                                                                                                         X
Who can a CNA accept direction from                                21-23                                                                                                                                                                                                          X                               X                                                                                                                                                                                                 X
Working cooperatively with others                                  6-9; 21-23                                                                                                                                                                                                     X        X                      X                                                                                                                                                                              X                  X
Working in settings where a regular RN is not scheduled                                                                                                                                                                                                                                                           X                                                                                                                                                                                                 X

Death & Dying:                                                     chap. 22, 390-398                       X                              X           X                                                                                               X                           X                                                   X                                                   X                               X                                                                      X
Bereavement therpy for staff                                       396-397                                                                                                                                                                                                        X                                                                                                                                                                                                              X
Body alignment after death                                         398                                                                                                                                                                                X                           X                                                                                                                                                                                          X                   X
Care for property of resident after death                                                                                                                                                                                                                                         X                                                                                                                                                                                          X                   X
Caring for resident when death is imminent                         chap. 22, 390-398 X X                   X                                          X                        X             X                             X                  X                  X        X       X                   X                               X              X          X            X                       X                                              X            X           X          X        X       X                                   X               X               X             X                   X                X
Comfort/care of the dying client                                   394-395                                                                                                                                                                                                        X                                                                                                                                                                                                              X                  X
Coping mechanisms used by the family and facility staff            395-397                                                                                                                                                                            X                           X                                                   X                                                                                                                                                          X                                                                           X
Death and dignity                                                  398                                                                                                                                                     X                                                      X                                                                                                                                                                                                              X                                                                           X
Demonstrating concern                                              392-395                                                                                                                                                                                                        X                                                                                                                                                                                                              X                                                                           X
Emotional and spiritual needs of the patient and family            394-396                                                                X                                                                                                                                       X                                                   X                                                                                                                                      X                   X                                           X               X               X
End of life issues                                                 chap. 22, 390-398                                                                                                                                                                                              X                               X                   X                                                                                             X                                                            X
Family support/role of the family                                  395-396                                                                                                     X                                           X                                                      X                                                   X                                                                                                             X                                            X                  X                        X               X               X                                 X
Feelings and attitudes about death and influence of culture &      391-392; 394; 396                                                                                           X                                                                      X                           X                               X                                                                                                                                                                              X
religion
Grieving process                                                   394-397                                                                X                                                                                                           X                           X                                                                                                                                       X                                                                      X                                                           X               X
Hospice care                                                       393                                                                                                                                                     X                                                      X
Monitoring of the patient                                          393-393; 395                                                           X                                                                                                                                       X                                                                                                                                                                                                              X
Physical and psychological changes as death approaches             397                                                                                                                                                                                X                           X                                                                                                                                                                                                              X                                                           X
Post-mortem care                                                   398                                     X                              X                                    X                                           X                          X                           X        X                      X                   X                                                                                                                                                          X                  X                        X               X               X
Psychological needs of the family                                  395                                                                                                                                                                                X                           X                                                   X                                                                                                                                                          X                                                           X               X
Psychological needs of the patient                                 394-395                                                                                                                                                                            X                           X                                                   X                                                                                                                                      X                   X                                                           X               X
Religious/cultural beliefs                                         396                                                                                                                                                                                                            X                               X                   X                                                                                                                                                          X
Rights of the patient/resident                                     391                                                                    X                                                                                                                                       X                                                                                                                  X                                                                                           X                  X
Role of the CNA in the dying process                               chap. 22, 390-398                                                                                           X                                                                                                  X                                                   X                                                                                                                                                          X
Signs of approaching death                                         397                                                                    X                                                                                                                                       X                                                                                                                                                                                                              X
Stages of death and dying                                          392                                                                                                         X                                                                                                  X                                                                                                                                                                                                              X                  X
Terminally ill                                                     chap. 22, 390-398                                                                                                                                       X                          X                           X                                                                                                                                                                                                              X

Family Role and Community Resources                                chap. 6, 72-81
Assistance of the Alzheimer's Disease and Related Disorders Assn                                                                                                                                                                                      X
to the resident, family caregiver, and facility
Chronic stress on family systems                                   74-76                                                                                                                                                                              X                           X                                                                                                                                                                                                              X
Community resources and their role in the care and treatment of                                                                           X                                                                                                           X                                                                               X
Alzheimer and related disorders residents inside and outside the
facility setting
Definitions - family, significant other, sandwich generation       6; 73                                                                                                                                                                              X
Family as a source of emotional support                            74; 77-80           X X                                                                                                   X                                                X                           X       X                                                                  X          X            X                                                                      X            X           X          X                                                                                    X             X                   X
Family caregiving prior to nursing home placement                  74-75                                                                                                                                                                              X                                                                                                                                                                                                                                          X
Family interactions                                                78-80                                                                  X                                                                                                                                       X                                                                                                                                                                                                              X



                                                                                                                                                                                                                                              9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 39 of69
                                                                                                                                              Summary of State CNA Curriculum




                                                                                          Federal Regulations




                                                                                                                                                                                               District of Columbia
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Family orientation to facility                                        76                                                                                                                                                                                                                                                                                                                                                                                                                               X                                                                           X
Impact on the primary caregiver                                       74-76                                                                                                                                                                                 X                                                                                                                                                                                                                                          X
Interventions for assisting family caregivers to coping with stress   74-76                                                                                                                                                                                 X                                                                                                                                                                                                                                          X
Role changes and role reversal                                        76                                                                                                                                                                                    X                                                                                                                                                                                                                                          X
Stress and coping techniques - nurse aide, family, resident in caring 27-28; 774-76                                                                                                                                                                                                     X                                                                                                                                                                                          X                   X
for the cognitively impaired
Utilization of resources                                              77-78                                                                                                                                                                                                                                                                                                                                                               X

Food Service Principles:                                              chap. 17, 320-334                                                                                              X                                                                                                                                                                                                                                                                                                                 X

Adaptive equipment for eating                                         329                                                                                                                                                                                                               X                                                   X                                                                                                                                      X                   X
After meal care                                                       327                                                                                                                                                                                                               X        X
Approaches for maintaining good nutrition and enhancing mealtime      322; 324-325                                                                                                                                                                          X                           X                               X                   X                                                                                                                                      X                   X
Assistance with meal setup                                            326                                                                                                            X                                                                                                                                                                                                                                                                                                                 X
Basic food service                                                    chap. 17, 320-334                          X                                                                                                                                                                      X                                                   X                                                   X                                                                                  X
Checking food tray against diet list                                  323-324; 326                                                                                                                                                                                                               X
Cultural/religious preferences                                        322                                                                                                                                                                                                               X                                                                                                                                                                                                                                                                          X
Food, principles of health and sanitation                             327                                                                                                                                                                                                               X                                                   X
How to read menus                                                     326                                                                                                            X
Offering substitutions                                                322; 327; 329                                                                                                  X                                                                                                  X
Preparing residents for meals                                         324-325                                                                                                                                                                                                           X                                                                                                                            X          X
Principles of a pleasant dining experience                            324-325                                                                                                        X                                                                                                  X                                                   X                                                                                                                                                          X
Proper feeding technique                                              326-327           X X                                                                                                        X                             X                  X                                   X                                                   X              X                       X                       X                    X                         X            X           X          X        X                                                                                         X
Serving meals/collecting trays                                        326-327                                                                                                                                                                                                                    X                                                                                                         X                    X
Serving to residents seated at same time                              326                                                                                                            X
Signs & symptoms that required alerting a nurse                       328-329                                                                                                        X                                                                                                  X                                                                                                                                                                                          X
Tray Preparation                                                      326                                                                                                                                                        X
Types of diets/food groups                                            323-324; 528-531                                                                                                                                           X                          X                           X        X                                          X                                                                        X                                                             X
Utilizing the tray card                                               323; 326                                                                                                       X

Growth and Development:                                               34-43; 478-482                                                                                                                                                                        X                                                                                                                                                                                                                                          X
Activities based on mood and behavior needs                           68-69                                                                                                                                                                                 X                                                                                                                                                                                                                                                                                      X                               X
Adjustment to institutional living                                    251-252                                                                                                                                                                                                           X                                                   X                                                                                                                                      X                   X
Aging process/health problems related to it                           chap. 11, 164-212 X X                      X                                                                                 X                             X                  X       X                           X        X                                          X              X                       X                       X         X                    X                            X           X          X        X                  X                                        X                             X                                    X
Aging stereotypes and myths                                                                                                                                                                                                                                                             X                                                                                                                                                                                                              X                                                           X
Awareness of developmental tasks associated with aging                5-6; 411; 421-424 X X                                                                                                        X                                                X                                                                                                      X                       X                                                                      X            X           X          X        X                                           X                                             X                   X
Awareness of resident's life experiences, hobbies                     15-19; 33-34; 41-                                                                                                                                          X                                                      X
                                                                      43; 63-69
Basic human needs                                                     34-41; chap. 5, 60-                        X        X                                                                                                                                 X                           X                                                                                                                                                                                                                                 X
                                                                      70
Cardio-vascular system, changes in                                    181-187                                                                                                                                                                                                                                                                                                                                                                                                                          X
Characteristics of a normal aged person                               chap. 11, 164-212                                                                                                                                                                                                 X                                                                                                                                                                                                              X

Communication needs                                                   15-16; 37-38; 84-                                                                                                                                                                                                 X
                                                                      93; 415-416




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                                                                       2008
Cultural Factors                                                       18-19; 39-40; 396                       X                                                                   X                                                                                                  X                                       X                                                                                                         X                                        X                                                                               X                                                                  X
Developmental needs                                                    34-41; 413; 478- X          X           X        X                                                                        X                             X                  X                  X        X       X                                                                  X          X            X                       X                              X                            X           X          X                           X                                                        X             X
                                                                       482; 492-493
Digestive system, changes in                                           188-192                                                                                                                                                                                                                                                                                                                                                                                                                       X
Diversionary activities for the resident                               18-19; 37-38; 51;                                                                                                                                       X                                                      X        X                                                                                                                                                                                                     X
                                                                       68-69; 414-415
Emotional needs                                                        39                                                         X                                                X                                           X                          X                           X                   X                   X           X                                                                                             X                                                            X
Endocrine system, changes in                                           201-204                                                                                                                                                                                                                                                                                                                                                                                                                       X
Expression of emotional needs                                          39                                                                                                                                                                                                             X                                                                                                                                                                                                              X
Family involvement                                                     chap. 6, 72-81                                                                                                                                          X                                                      X                                                   X                                                                                                                                      X                   X                  X
Fulfillment of resident's maximum potential within the aging process   36; 397; 420-21                                                                                             X                                                                                                  X                                                   X
Hearing                                                                90; 202-03                                                                                                                                              X                                                      X                                                                                                                                                                                                              X                                                                           X
Importance of client rest/sleep/socialization/activity schedules       51; 385; 517                                                                                                                                                                                                                                                                                                                                                     X                                        X                   X                  X                                                        X
Importance of familiar tasks to support normalization                  40-41; 68-69; 408-                                                                                                                                                                 X                                                                                                                                                                                                                                          X
                                                                       409; 412-413
Intervention skills                                                    chap. 23, 402-424;                                                                                                                                      X
                                                                       chap. 27, 490-508;
                                                                       etc.
Maslow's heirarchy of needs                                            36-41                                                                                                                                                                                                          X                                                                                                                                                                                                                                 X                        X
Mental health                                                          92-93; chap. 23, X          X           X        X         X                       X           X            X             X                                       X        X                                                       X           X       X                          X          X            X            X                                                         X            X           X          X XX             X                    X              X                               X             X X                 X      X         X
                                                                       402-424
Modifying behavior in response to resident's behavior                  90-98; 418-421     X        X                                                                                             X                                                X                                   X                                                                  X                       X                       X                                              X            X           X          X        X                                           X                                             X                   X
Nervous system, changes in                                             198-200                                                                                                                                                                                                                                                                                                                                                                                                                       X
Nurse aide/resident relationships                                      15-20; chap. 3, 32-                                                                                                                                     X                                                      X                                                                                                                                                                                                              X
                                                                       44;51-51; chap. 5,
                                                                       60-70; 86-98; 217-
                                                                       18; 220-224; 394-
                                                                       395; 412-424; 513-
                                                                       514; etc.
Patience and tolerance of abnormal behavior                            93-95; 412-424                                                                                                                                          X                                                      X                                                                                                                                                                                                              X
Perserving dignity                                                     chap. 5, 60-70;                                                                                                                                         X                                                      X                                                   X                                                                                                                                                          X
                                                                       218; 339; 413
Physical and occupational skills                                       chap. 27, 490-508                                                                                                                                                                                              X                                                                                                                                                 X
Physical changes associated with aging                                 chap. 11, 164-212                                                                                                                                       X                                                      X                                                    x                                                             X                                                                                           X       X                                                   X
Physiological needs                                                    36-37                                                                                                                                                                              X                           X                                                                                                                                                 X                                        X                                      X
Promoting client's skin integrity - race, age, ethnic                  171-173; chap. 19,                                                                                                                                                                                             X                                                                                                                                                                                                                                                                          X               X
                                                                       354-364
Psychological needs                                                    37-41; 408-415                                                                                                                                                                     X                           X                                                                                                                            X                                                             X                           X          X
Recreational needs                                                     68-69                                                                                                       X                                                                                                  X
Resident behaviors                                                     90-98; 414-421                                                                                                                                                                                                 X                                                   X                                                                                                                                                                  X                                                                   X
Resident conflicts                                                     95-98                                                                                                                                                   X
Resident's self-care                                                   38; 218; 269; 297-                                                                                          X                                           X                                                      X                                       X                                     X                                    X                                                                                           X                                                                           X
                                                                       298; 491
Respect of beliefs, values, feelings                                   39-40; 218; 296-                                                                                                                                        X                                                      X                                                                                                                                                                                                              X
                                                                       98
Respiratory system, changes in                                         177-181                                                                                                                                                                                                                                                                                                                                                                                                                       X
Responding appropriately to resident's behavior                        89-98; 414-421     X        X                                                                                             X                             X                  X                  X        X       X                                                                  X          X            X                       X                                              X            X           X          X        X                                                                           X             X                   X                X



                                                                                                                                                                                                                                                  9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 41 of69
                                                                                                                                          Summary of State CNA Curriculum




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Security and belonging                                                37-38                                                                                                                                                                                                         X                                                                                                                                                                                                        X
Self-worth and self-esteem                                            38                                                                                                                                                                                X                           X                                                   X                                                                                                                                                    X                                                                 X
Sexuality                                                             39                                     X                                                                                                               X                                                      X                                                   X                                                                                                                                      X             X                        X                                                        X
Sleep patterns                                                        385                                                                                                                                                                                                                                                                                                                                                                                                      X             X                                                                                 X
Smell and touch, loss of                                              208                                                                                                                                                                                                                                                                                                                                                                                                                    X
Social service needs                                                  37-38             X X                  X        X         X                       X           X            X             X                             X         X        X       X                           X                   X                               X              X          X            X            X                    X                                    X            X           X          X X              X          X         X                                              X             X X                 X                X
Spiritual/Religious needs                                             39-40; 396                                                                                                 X                                           X                          X                           X                                       X           X                                                                                                                                      X                                      X
Stress management                                                     27-28; 526                                                                                                                                                                                                    X
Urinary system, changes in                                            193-198                                                                                                                                                                                                                                                                                                                                                                                                                      X
Utilizing resident's family as source of emotional support            chap. 6, 72-81    X X                           X                                                          X             X                             X                  X                  X                X                   X                                              X                       X                                                                                   X           X          X        X                                                                           X             X                                    X
Vision                                                                204-206                                                                                                                                                X                                                      X                               X                                                                                                                                                                              X                                                                           X
Vision - changes in                                                   204-206                                                                                                                                                                                                                                                                                                                                                                                                                      X
Vision - diseases                                                     204-206                                                                                                                                                                                                                                                                                                                                                                                                                      X

Legal Issues:
Legal Issues (general)                                                9-10; 22; 46;                          X        X                                                                                                                                                             X                               X                                                                       X                                                                                                      X                  X                        X
                                                                      55;132-34; 417
Legal terms in abuse                                                  55-57                                                                                                                                                                                                                                                                                                                                                                                                                        X
Legal issues of charting                                              102; 108-114; 161                                                     X                                                                                                                                       X                                                                                                                                                                                                              X
Drugs administration - legal & ethical aspects                                                                                                                                                                                                                                      X                                                                                                                           AC
Function of the CNA and legal limitations/implications                24-27                                                                 X                                    X                                                                      X                           X                               X       X                                                                                                         X                                                                    X          X                                                                                                           X
Understanding legal consequences of abuse                             53-57                                                                                                                                                                                                         X
Understanding the legalities of documenting and reporting incidents   112-114; 161                                                                                               X                                                                                                  X                                       X                                                                                                                                                                      X                                           X
and accidents

Nutrition and Hydration:                                              chap. 17, 320-334                                                                                                                                                                                             X                               X       X           X                                                              X                              X                                                            X
Assisting with eating and hydration                                   323-330; 421-422 X X                                                                                       X             X                             X                  X       X          X        X       X        X                      X       X           X              X          X            X                       X                    X                         X            X           X          X        X                  X                        X                               X             X                   X                X
Basic principles of nutrition and hydration                           322-324; 330-331;                                                                                                                                                                                             X                                                                                                                  X                                                                                                              X                        X               X
                                                                      528-531
Body functions                                                        chap. 11, 164-212                                                                                                                                                                                             X                               X                                                                                  X                                                                                                   X                                                                   X
Client's right to refuse nutrition                                    47; 322; 327                                                                                                                                                                                                  X                                                                                                                                                                                                                                 X
Concepts of therapeutic diets including dysphagia diets and risks     323-324; 328                                                                                               X                                                                      X                           X                               X                   X                                                                                                                                                          X                  X                                        X
Deviations from normal food and fluid intake and output               189; 321-24; 328-                                                                                                                                                                                             X                                                                                                                                                                                          X                   X
                                                                      331
Diet therapy                                                          321-324                                                               X                                                                                                                                       X                                                                                                                                                                                                              X
Distribution of nutrients                                             320-322; 331-333;                                                                                                                                                                 X                           X
                                                                      528-531
Effect of aging process on digestion                                  188-192                                                                                                    X                                                                                                  X                                                                                                                                                                                                              X
Enteral nutrition/tube feeding                                        330; 443-445                                                                                               X                                                                                                  X
Factors affecting nutrition state of the elderly                      328-331                                                                                                                                                                                                       X                                                                                                                                                                                                              X                                                           X
Feeding problems, complications and eating behaviors                  328-330;                                                                                                                                                                          X                           X
Feeding/hydration techniques                                          324-328           X X                  X                              X           X                        X             X                             X                  X       X          X        X       X                               X                   X              X          X            X                       X         X                    X               X            X           X          X                           X                        X               X               X             X                   X                X
Fluid balance in the body                                             330-333                                                                                                                                                                           X                           X                                                   X                                                                                                                                                          X
Forcing and restricting fluids                                        332                                                                                                                                                    X                          X                           X
Identify risk factors for poor nutrition                              328-329                                                                                                    X                                                                                                  X
Intermittent nourishment and dietary supplements                      329-330                                                                                                                                                                           X                           X
Loss of appetite                                                      320; 328-329                                                                                                                                           X                                                      X



                                                                                                                                                                                                                                                9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 42 of69
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Malnutrition, dehydration and fluid overload                       330-331                                                                                                      X                                           X                                                      X                                                   X
Measuring and recording fluid and food intake and output           195; 331-333                             X                              X           X                        X                                           X                          X                           X        X          X           X       X           X                                                                        X          X         X                                        X                   X                  X                        X                               X                                                  X
Modified Diets                                                     323-324                                                                                                                                                                                                         X                                                   X                                                                                   X                                                                      X                                                           X
NPO (Nothing by Mouth)                                             87; 450                                                                                                                                                  X                                                      X                                                                                                                                                                                                              X
Nutrition and bodily waste                                         188-198; 331-333                                                                                                                                                                                                X                                                                                                                                                 X
Nutrition and fluid intake                                         331-333; 528-531                         X                                                                                                                                          X                           X                   X           X                                                                                            X                                                             X                   X                                           X
Preventing dehydration                                             331; 421-422                                                                                                                                                                                                    X                               X                   X                                                                                                                                                          X                  X                        X
Principles/physiology of nutrition and hydration                   528-531                                  X                                          X                        X                                                                      X                           X                   X           X                                                                                                                                                          X                   X       X                                                   X
Proper nutritional care                                            528-531                                                                 X                                                                                                                                       X                                                                                                                                                                                                              X
Reporting signs of malnutrition and dehydration                    328-329; 331                                                                                                 X                                                                                                  X                               X                   X                                                                                                                                      X
Role of food service                                               321-322                                                                                                                                                                                                                                                                                                                                                                                                                        X
Supplemental feeding                                               329-330                                                                                                                                                                                                         X                                                                                                                                                                                                                                                                          X
Swallowing difficulties                                            328                                                                                                                                                      X                                                      X                                                                                                                                                                                                                                                                          X
Symptoms of dehydration                                            331                                                                                                                                                      X                                                      X                                                   X
Syringe feeding                                                                                                                                                                                                             X                                                      X

                                                                     chap. 8, 102-116;
Observation, Reporting, and Recording Skills:                        chap. 13, 230-248                                                                                                                                                                                                                             X       X X                                                                        X                              X                                                            X
                                                                     17; 107-108; 219;
Attitude and actions needed for making observations                  526-527                                                                                                                                                                                                                                                                                                                                                                                                                      X                  X
Charting                                                             104-115                                                                                                                                                                           X                                                           X                                                                       X          X        AC                                                                                 X       X
Comparison to previous observations                                  105; 112; 243                                                                                                                                                                                                                                 X                                                                                                                                                                              X                  X
                                                                     15-18; chap. 8,                                                                                                                                                                                                                                       X
                                                                     102-116; chap. 13,
                                                                     230-248; 331-334;
Data Collection                                                      344-349                                                                                                                                                                                                       X                               X                                                                                                                                                                              X
                                                                     15-18; chap. 8,
Demonstrate observation and documenting skills needed in support 102-116; chap. 13,
of the assessment of resident's health, physical condition and well- 230-248; 331-334;
being                                                                344-349                                                   X                                                                                                                                                   X                               X                                                                                                                                                                              X
Forms used in the medical record system                              chap. 8, 102-116                                                                                                                                                                  X                                                           X                                                                                                                                                                              X
                                                                     113-115;
                                                                     Appendix A, 546-
How to record observations in common medical terminology using       555; Appendix B,
board approved abbreviations and procedures                          556                                                                                                                                                                                                           X                               X                                                                                                                                                                              X                  X
                                                                     170; 368; 219;
Importance of reporting abnormal changes in body functioning to a 243; 324; 339;
supervisor                                                           356; 382-384      X X                                                                                                    X                                                X                                   X                               X                                  X                       X                       X                    X                         X            X           X          X        X                                                                           X             X                   X
                                                                     115; App. A, 546-                      X                                                                                                                                          X                                                                                                                                                       AC                                                                                                    X
                                                                     555; App. B, 556;
Medical terminology and abbreviations                                App. C, 558-560                                                       X                                                                                                                                       X                               X                                                                                                                                                                              X
Noting and recording results of simple laboratory tests              344-349                                                                                                                                                                                                                                       X                                                                                                                 X
Observation/Documenting skills                                       15-18; chap. 8,                                 X                                 X                        X                                           X                          X                           X        X          X           X       X                                                                                                                                                  X                   X                  X
                                                                     102-116; chap. 13,
                                                                     230-248; 331-334;
                                                                     344-349




                                                                                                                                                                                                                                               9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 43 of69
                                                                                                                                          Summary of State CNA Curriculum




                                                                                      Federal Regulations




                                                                                                                                                                                           District of Columbia
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                                                                                                                                                                                                                                                                                                                                      Massachusetts




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                                                                                                                                                                                                                                               Idaho
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Utah
                                                                     2008
                                                                     15-18; chap. 8,
                                                                     102-116; chap. 13,
                                                                     230-248; 331-334;
Observations of patients and reporting responsibility                344-349                                                                X                                                                                                                                       X                               X                                                                                                                                                                              X                                           X
Patient care plans and documentation                                 103; 109-111                                                           X                                                                                                                                       X                               X                   X                                                                                                                                                          X                                           X
Care plan meeting                                                    110-111                                                                                                                                                                                                                                                                                                                                                                                                                       X
Procedures after report of abuse is made                             54; 56-57                                                                                                                                                                                                                                                                                                                                                                                                                     X
Recording and reporting                                              chap. 8, 102-116;                       X                              X           X                        X                                                                                          X       X        X                      X       X           X                                                   X          X                                                                                           X                  X                        X
                                                                     chap. 13, 230-248
Reporting accidents                                                  112; 161                                                                                                                                                                                                       X                                                                                                                                                                                                              X
Reporting of abuse, mistreatment and neglect                         54; 56-57                                        X                                 X                        X                                                                                                  X        X          X           X                   X                                                                                             X                                                            X       X          X                        X
Reporting suspected abuse                                            54; 56-57          X X                                                                                                    X                                                X                                   X                               X                   X              X                       X                                                                                   X           X          X        X                                                                                         X                   X
Reports and records incidents                                        112; 161                                                                                                                                                                                                       X                                                                                                                                       X                                                                      X
                                                                     16-17; 88-89; 106-
Use of senses to observe                                             107; 219; 236-244;                                                                                                                                                                                                                             X                                                                                                                                                                              X                  X
Weights and measures - metric system, military time, liquid volume   331-334
                                                                     333                                                                    X
                                                                     16-18; chap. 8,
                                                                     102-116; 236-244;
                                                                     331-334; 328-329;
What to Observe                                                      344                                                                                                                                                                                                            X                               X                                                                                                                                                                              X                  X
                                                                     chap. 8, 102-116;
When and how to report observations                                  chap. 13, 230-248                                                                                                                                                                                              X                               X                                                                                                                                                                              X                  X

Personal Care Skills:                                                chap. 16, 294-    X         X                                                                                             X                                                X                                                                                                      X                       X                                                                                   X                      X                                                                                                  X
                                                                     317, etc.                                                                                                                                                         X                                                                            X                                                                                  X                                              X                        X                 XX                             X              X               X               X                        X              X          X
Assistive devices                                                    329; 494-496                                                                                                                                                                                                                                                                                                                                                                                                                 X
Back and foot care                                                   300; 314; 432; 496-                                                                                                                                                                X                                                           X                                                                                                                                                                             X                                            X
                                                                     498; 506
Basic hygiene techniques                                             125-126                                                                                                                                                                                                        X                               X       X                                                               X                                                                                                      X
Bathing:                                                             298-306; 423                                                                                                                                                                                                                                                                                                                                                                     X                                            X
   Bathing (tub/shower/partial)                                      302-305           X         X           X                              X           X                        X             X                             X                  X       X          X        X       X        X          X           X                   X              X          X            X                       X         X          X         X                            X           X          X        X                  X                        X               X               X             X                   X                X
   Bed baths                                                         299-301                                                                                                                                                 X                                     X                X        X                      X       X           X              X                                               X                    X                                                                      X                                           X
   Medicinal baths                                                   304                                                                    X
   Showers                                                           303                                                                                                                                                     X                                     X                                                X                   X                                                              X                    X                                                                      X                                           X
   Sitz bath                                                         467-470                                                                                                                                                                                                                                        X                                                                                                                                                                                                                          X
   Whirlpools                                                        305                                                                                                                                                     X                                                      X                               X                                                                                                       X                                                                      X
Bedside commodes                                                     339-340                                                                                                                                                 X                                     X                X                                                                                                                                                                                          X
Brushing teeth                                                       307                                                                                                                                                                                                                                                                                                                                                                                                                           X
Care of dirty clothing                                               142; 255; 258                                                                                                                                           X
Care of hearing aids and orthotics                                   207; 255; 496-499 X         X                                                                                             X                             X                  X                                   X                                                                  X                       X                                                                                   X           X          X                                                                                                  X
Catheter care                                                        196-197                                                                                                     X                                                                      X                           X        X                              X           X              X                                                                    X                                                  X                   X                  X                        X
Changing Gown                                                        128-130                                                                                                                                                                                       X
Denture Care                                                         308-309                                                                                                                                                 X                                     X                X        X                              X                          X                                                                    X                                                                      X                  X                                        X
Drape and Undrape                                                    298-306                                                                                                                                                                                       X                X
Dressing/Undressing                                                  314-316; 422-423 X          X           X                              X           X                        X             X                             X                  X       X          X        X       X        X          X                   X           X              X          X            X                       X         X          X         X               X            X           X          X        X                  X                                        X               X             X                   X                X
Ear care                                                             207                                                                                                                                                                                                            X                                                                                                                                                                                          X
Enemas - types/administration                                        190                                                                    X                                    X                                                                      X                           X        X                      X                                                                                            X          X                                                  X                                      X                                        X



                                                                                                                                                                                                                                                9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 44 of69
                                                                                                                         Summary of State CNA Curriculum
                                                                                                                                                                            Training Requirements




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                                                                                                                                                                                                                                                                                                                                                                                                                   New Hampshire
                                                                                                                                                                                                                                                                                                                     Massachusetts




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           South Carolina
                                                                                                                                                                                                                                                                                                                                                                                                                                                                        North Carolina




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             Pennsylvania

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Ohio




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Utah
                                                   2008
Excretory system                                   188-200                                  X                                                                                                                                                                      X                               X                                                                                                                                                          X
Eye care                                           204-206                                                                                                                                                                                                         X                                                   X
Flossing                                           304; 307                                                                                                                                                                                                                                                                                                                                                X
Foot care                                          314; 432; 506                                                                                                                                            X                                                      X                               X       X           X
Grooming                                           310-314; 423-424 X           X           X                              X           X                        X             X                             X                  X                  X        X       X                   X           X       X                          X          X            X                       X                              X               X            X           X          X                           X                                        X               X             X                   X                X
Hair care (shampoo/grooming)                       304; 306                                                                X                                                                                X                          X          X                X        X                      X       X           X              X                                               X         X          X                                                  X                   X                  X                        X                               X
Heel and elbow protectors                          360-361                                                                                                                                                                                        X                X                               X
                                                   193-196; 340; 344;
Incontinence                                       421                                                                                                                                                                                                             X        X                      X                 X                                                                          X          X                                                  X                   X                  X
Incontinence - causes                              195; 421                                                                                                                                                                                                                                                                                                                                                                                                                       X
Incontinence - prevention                          191; 196-197                                                                                                                                                                                                                                                                                                                                                                                                                   X
Laxatives/Suppositories                            189                                                                     X                                                                                                                                       X                               X
Nail care                                          313-314                                                                 X                                                                                X                          X          X                X        X                      X       X           X              X                                               X         X          X                                                  X                   X                  X                        X                               X
Oral Hygiene                                       304; 307-309      X          X           X                              X           X                        X             X                             X                  X       X          X        X       X        X          X           X       X           X              X          X            X                       X                    X                         X            X           X          X        X                  X                        X                               X             X                   X                X
Oral Hygiene for the Unconscious                   309                                                                                                                                                                                            X                X        X                                                                                                                   X          X                                                                      X
Ostomy care                                        349-351                                                                                                                                                                                                         X                                                                                                                                       X                                                  X                                      X                        X               X
Perineal care/catheter care                        194-197; 300-301                                                                                                                                         X                                     X                X        X                      X       X           X              X                                                                    X                                                  X                   X                  X
Personal Care Skills                               chap. 16, 294-317,X          X                                                                                             X                                       X        X                           X       X                               X                                  X                       X                                 X                  X                              X           X          X        X       X                                                   X                             X
                                                   etc.
Personal Hygiene                                   125-126; 304; 423                        X        X                                                                                                                                                             X                               X                                                                       X          X                                                                                                   X
Rest, sleep, comfort                               chap. 21, 380-387                                                                                                                                                                                               X                                       X                                                                                                                                                  X                   X                                                                           X
Shaving /Safety razors-electric razors             310-313                                                                 X                                                                                                           X          X                X        X                                          X                                                                        X          X                                                                      X                  X                        X
Skin care                                          chap. 19, 354-364 X          X           X                              X           X                        X             X                             X                  X       X          X        X       X                   X           X                   X              X          X            X                       X                    X                         X            X           X          X        X                  X                        X               X                             X                   X                X
Toileting                                          chap. 16, 294-317,X          X           X                                          X                        X             X                             X                  X                  X        X       X                   X           X                                  X          X            X                       X                                              X            X           X          X        X                  X                        X               X               X             X                   X                X
                                                   etc.
Urinary Drainage Bags - empty & change             196-198                                                                                                                                                                                        X                X                               X                                  X                                                                    X                                                  X                   X                  X                        X
Use of bedpans/urinals                             339-343                                                                                                      X                                           X                                     X                X        X                      X       X                          X                                                         X          X                                                  X                   X                  X                        X
Vaginal douches - internal and external                                                                                                                                                                                                X                           X                               X

Resident's Independence                                                                     X        X                                 X                                                                                               X                                               X                               X                                                              X                                                                                                                                       X                                                        X        X
Assisting in maintaining functional independence   26; 50-51; 66; 218;                                         X                                                                                                                                                   X                                                                                                                                                                                                              X                                           X
                                                   269; 296-97; 491
Assisting in use of telephone                                                                                                                                                                                                                                               X                                                                                                                                                                                                     X
Daily living activities                            297-298, 499-500                                                        X                                                                                X
Decision making                                    50-51; 218                                                                                                                                               X                                                      X                                                                                                                                                                                                              X
Independence in eating                             327                                                                                                                                                                                                                                                                                                                                                                                                                            X
Loss of independence                               251; 254                                                                                                                                                                                                                                                                                                                                                                                                                       X
Participating in resident activities               68-69; 296; 414-                                                                                                                                         x                                                                                                                                                                                                                                                                                                                                                 X
                                                   415
Plan of care to meet resident's needs              108-111                                                                                                                                                  X                                                      X        X
Promoting highest level of functioning             26; 50-51; 66; 218;                                                     X                                                                                                                                       X                                                                                                                                                                                                              X
                                                   269; 296-97; 491
Promoting resident's independence                  50-51; 218; 296- X X                                                                                                       X                             X                  X                           X       X                                       X           X              X                       X                       X                                              X            X           X          X        X       X          X                        X                               X             X                   X                X
                                                   297; 412-413; 491

Residents' Rights:                                 chap. 4, 46-58      X X                  X        X                     X           X           X                          X                             X         X        X       X                           X                   X           X       X           X              X          X            X            X          X         X                                    X            X           X          X        X       X                    X              X               X               X             X X                 X                X




                                                                                                                                                                                                                               9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 45 of69
                                                                                                                                                   Summary of State CNA Curriculum




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                                                                                                                                                                                                    District of Columbia
                                                                                                                                                                                                      Training Requirements




                                                                                                                                                                                                                                                                                                                                                                                                                                             New Hampshire
                                                                                                                                                                                                                                                                                                                                               Massachusetts




                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     South Carolina
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  North Carolina




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Pennsylvania

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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  North Dakota
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                          New Mexico
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                                                                                                                                                                                                                                                                                                                                                                                      Mississippi




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         Utah
                                                                           2008
Assistance in resolving disputes and grievances                            52; 57; 95-98         X X                                                             X                        X             X                             X                  X                  X        X       X                   X                                              X          X            X                       X                                              X            X           X          X                X          X                        X                               X             X                   X                X

Assistance to participate in resident and family groups /activities.       77-80; 316            X X                                                                                      X             X                             X                  X                  X        X                           X                                              X          X            X                       X                                              X            X           X          X                           X                        X                               X             X                                    X

Assisting a resident to vote                                               48                                                                                                                                                                                                                                    X                                                                                                                                                                                          X
Awareness of how to file a complaint regarding operations within           52; 57                                                                                                                                                                                                                                                                                                                                                                                                                           X
the provider setting
Care and security of personal possessions                                  51; 255               X X                                                             X                        X             X                             X                  X       X          X        X       X                   X           X                                  X          X            X                       X                                              X            X           X          X        X       X          X                        X                               X             X                   X                X
Cultural Diversities                                                       19; 40; 322; 396                                                                                                                                           X                                                      X                                                                                                                                                                                          X                                                                               X
Discuss negative outcomes of physical restraints                           53-56; 154-155                                                                                                 X                                                                                                  X                                                                                                                                                                                                              X
Freedom from abuse, mistreatment, neglect                                  53-57                 X X                                                             X                        X             X                             X                  X                  X        X       X                   X                               X              X          X            X                       X                                              X            X           X          X                X          X                        X                               X             X                   X                X
Freedom from fear                                                          53-57                                                                                                                                                                                                             X                                                                                                                                                 X
Freedom from restraints                                                    53-57; 154-155        X X                                                                                                    X                             X                  X                  X        X       X                               X                   X              X          X            X                       X                                              X            X           X          X        X       X          X                                                        X             X                                    X
Identifying religious symbols and artifacts                                40                                                                                                                                                                                                                                                                                                                                                                  X
Identifying violations of confidentiality or human rights                  49-57                                                                                                                                                                                                                                                                                                                                                               X                                                            X
Informing residents of their rights                                        47-50
Procedures for determining competency                                                                                                                                                                                                           X                                                                                                                                                                                                                                                                                        X
Promoting privacy/maintaining confidentiality                              47-49                 X X                                                             X                        X             X                             X                  X       X          X        X       X                   X                               X              X          X            X                       X                              X               X            X           X          X        X       X          X                        X                               X             X                   X                X
Promoting resident's rights                                                chap. 4, 46-58        X X                                     X                                                              X                                                X                                   X                                                   X              X                       X                                                                      X            X           X          X        X                                           X                                             X
Psychological impact of abuse, neglect, mistreatment or financial          53-57                                                                                                          X
exploitation
Recognize the role of client advocacy groups as client resources
Recognizing the role of state and federal regulatory agencies in           53-57
approving providers and in investigating complaints of abuse
Reinforcing behavior consistent with resident's dignity                    61-68                 X X                                                                                      X             X                                                X                  X        X                           X                                              X          X            X                       X                                              X            X           X          X                                                                                    X             X                   X                X
Residents' Bill of Rights                                                  chap. 4, 46-58                                                                                                                                             X                                                               X                                          X
Respect of client's differences (ethnic, cultural, social, generational,   19; 40; 322; 396                                                                                                                                                                                                  X                                                                                                                                                                                          X                                                                               X
religious)
Respecting rights of the resident                                          chap. 4, 46-58        X X                                                                                                    X                             X                  X                           X       X                               X                                  X                       X                                            X                         X            X           X          X        X       X                                                                   X             X                   X                X
Respect and dignity                                                        61-68                                                                                                                                                      X                                                      X                                                   X                                                              X                                                                       X                                                                                                                                 X
Right to make personal choices                                             50-51                 X X                                                             X                        X             X                             X                  X       X          X        X       X                   X                                              X          X            X                       X                                              X            X           X          X        X       X          X                        X                               X             X                   X                X
Self-administration of medicines                                           50; 369                                                                                                                                                                                                           X
Values and ethics                                                          18-20                                                                                                                                                      X                                                      X                               X                                                                                                                                                                                                                                          X

Safety/Emergency Concepts:                                                 chap. 10, 140-        X X                           X                     X           X                        X             X                                                X       X                   X       X                   X           X       X           X              X                       X            X          X                              X               X            X           X          X XX                        X                        X               X               X             X X                 X                X
                                                                           161; chap. 12,
                                                                           366-377
Abuse, what constitutes abuse                                              53-57                                                                                                                                                                                                             X                               X                   X                                                                                                                                                          X
Basic life support                                                                                                    X
Body mechanics                                                             151-153                                    X                              X                                    X                                           X                          X                           X        X          X                               X                                                              X                    X                                                                      X       X          X                        X               X
Burns                                                                      374-375                                                                                                                                                                                                           X                               X                                                                                            X                                                                                 X
Call for help and assisting resident until help arrives                    155-56; 284; 369;                                                                                              X                                                                                                  X
                                                                           372; 373; 374;
                                                                           375; 376
Cardiopulmonary resuscitation (CPR)                                        369-371                                             X                                                                                                                                 X                           X                   X                               X                                                                                   X                                                  X                                      X
Choking/obstructed airway                                                  187; 371-373                                                                                                   X                                                                      X          X                X        X                                          X                                                                        X                                                                                 X                  X                                        X               X
Combative behavior                                                         94-95; 417                                                                                                                                                                                                        X




                                                                                                                                                                                                                                                         9/29/2013                                                                                                                                                                                                                                                                                                                                                       Page 46 of69
                                                                                                                                Summary of State CNA Curriculum




                                                                            Federal Regulations




                                                                                                                                                                                 District of Columbia
                                                                                                                                                                                   Training Requirements




                                                                                                                                                                                                                                                                                                                                                                                                                          New Hampshire
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Utah
                                                           2008
Communicable and infectious diseases                       chap. 9, 118-137                                                                                                                                                                                               X                               X                                                                                                                                                                                                 X
Contributing factors of abuse                              56                                                                                                                                                                                                                                                                                                                                                                                                                            X
Control of Bleeding                                        375                                                                                                                                                                                                            X        X                                          X                                                                        X
Convulsions (Seizure)                                      373-374                                                                                                                                                                                                        X                                                                                                                            X                                                                                                                                                             X
Disinfecting/Sterilization                                 135-137                                                                                                     X                                           X                          X                           X                                                                                                                                                                                                                                                                          X
Distress - signs and symptoms                              chap. 12, 366-377                                                      X
Emergency codes                                                                                                                   X                                                                                                                                       X
Emergency procedures                                       chap. 10, 140-161;X X                                                  X                                    X             X                             X                  X                           X       X                               X                   X              X                       X                       X                              X               X            X           X          X        X       X          X                        X               X               X             X                   X                X
                                                           chap. 12, 366-377
Equipment - locked wheelchairs, bed position, side rails   154-155; 272; 499                                                                                                                                       X                                                      X                                                   X                                                                        X          X                                                                      X                                                           X
Ergonomics                                                 147-148; 272                                                                                                                                                                                                                                                                                                                                                                                                                  X
Eye wash stations
Fainting                                                   285; 373                                                                                                                                                                                      X                X        X
Falls - care of a patient who has fallen                   284; 290                                                                                                                                                X                                                      X                                                   X                                                                                   X                                                                                                                                                  X
Fire prevention                                            159                                                                                                                                                                                                                                                                                                                                                                                                                           X
Fire and disaster procedures                               159-160; App. D,                        X                              X                                    X                                                                      X          X                X        X                      X                   X                                                   X          X         X          X                                                                      X                                                           X
                                                           562-563
Fire drills                                                159                                                                    X                                                                                                                                                                       X                                                                                                                 X
Natural disasters                                          158-159                                                                                                                                                                                                                                                                                                                                                                                                                       X
General safety rules/procedures                            chap. 10, 140-161;X X                                                  X                                                  X                                                X                                   X                                                                  X                       X                                                                                   X           X          X                           X                                                                      X                   X
                                                           chap. 12, 366-377
Handling and disposal of hazardous wastes                  146-147                                                                X                                                                                                                                                                                                                                                                                                                                                                         X
Handling/disposal of contaminated materials                141-147                                                                X                                    X                                           X                                                      X                                                                                                                                                                                                                                 X
Handwashing - reasons for                                  119-124                                                                                                                                                                                                                                                                                                                                                                                                                       X
Handwashing techniques                                     125-126                                                                                                     X                                           X                          X          X                X        X                      X       X           X                                                              X         X          X                                                  X                   X                  X                                        X
Heimlich maneuver                                          165; 187; 272-273 X X                            X                                                          X             X                             X                  X       X                   X       X                                                   X              X                       X                       X                    X                         X            X           X          X        X       X          X                        X               X               X             X X                 X                X
HIV/AIDS/Hepatitis B                                       144-146; 211; 421                                                                                                                                       X                                                                                      X                                                                                                                                                                                                 X                                                        X
Identify fire hazards                                      156; 159                                                                                                    X                                                                                                  X                               X                                                                                  X                                                                                           X
Immediate and temporary intervention                       367                                                                    X
Incident reports                                           112; 161                                                                                                                                                X
Infection control/prevention                               chap. 9, 118-137 X X                    X        X                     X           X                        X             X                             X                  X       X                   X       X                   X           X       X           X              X                       X            X          X         X                    X               X            X           X          X XX             X                                   X                               X             X X                 X                X
Isolation - in the home                                                                                                                                                                                                                       X
Isolation - physiological aspects                          132-134                                                                                                                                                                            X
Isolation - psychological aspects                          134                                                                                                                                                                                X                                                           X
Isolation procedures                                       132-134                                 X                                                                   X                                           X                          X                           X                                                   X                                                                       X-                                                             X                   X                                                           X
Lighting                                                   91; 154; 252; 385                                                                                                                                                                                              X                               X                                                                                            X
                                                                                                                                                                                                                                                                                                                                                                                                      AC
Medical aseptic techniques/principles                      chap. 9, 118-137                        X                              X                                    X                                                                      X                           X        X                      X                                                                                  X                                                                       X                   X
Modes of transmission of organisms                         120-124                                                                X                                                                                X                          X                           X                               X                                                                                                                                                                              X
OSHA Standards                                             24; 132; 144-146                                                                                                                                                                                                                                                                                                                                                                                                                                 X                                                                                                           X
Oxygen safety                                              157-158; 435                                                                                                                                                                                                   X                                                                                                                                                                                          X                   X
Preventing burns                                           299; 302; 303;                                                                                                                                                                                                 X                               X                                                                                                                                                                                                 X
                                                           305; 374
Preventing falls                                           154-155                                                                                                                                                 X                                     X                X        X                                                                                                                   X                                                                                 X                  X
Prevention of Complications                                chap. 11, 164-212                                                                                                                                                                                              X
Proper gloving                                             126-128                                                                                                                                                                                       X                X
Reporting emergencies accurately                           112; 161                                                                                                    X                                                                                                                                                                                                                               X
Reporting non-functional equipment                         150; 156                                                                                                    X                                                                                                                                                                                                                                                                                                                 X



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                                                                                                                                     Summary of State CNA Curriculum
                                                                                                                                                                                        Training Requirements




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                                                                                                                                                                                      District of Columbia




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                                                                                                                                                                                                                                                                                                                                 Massachusetts




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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Utah
                                                              2008
Restraints/Protective devices                                 53-56; 154-155                            X                                                                   X                                           X                                     X                X        X                      X                   X                                                                        X          X         X                                        X                   X                  X                        X               X
Safety hazards                                                155-158                                                                                                                                                   X                                                      X                               X                                                                                                                                                          X                   X                  X
Seizures (Convulsions)                                        373-374                                                                                                                                                                                         X                X        X                                          X                                                                                                                                      X
Smoking                                                       157; 159; 181                                                                                                                                                                                                    X                                                                                                                            X                                                             X                   X
Standard Precautions/Accident prevention                      124-137; 141-159                          X                                                                   X                                           X                                                      X        X                      X       X           X                                                                        X          X                                                                      X       X          X
Symptoms of Infection                                         169-171                                                                                                                                                                                                          X                               X                   X                                                                                                                                                          X
Using the nurse call system                                   225-226; 257; 262                                                                                             X                                           X                                                      X        X                                          X                                                                                                                                                                             X

Symptoms and Basic Care Considerations:                                                                                                                                                                                                                                                                                                                                                                                                                                                       X
Alcoholism                                                    410                                                                                                                                                                                                                                                                                                                                                                                                                                                X
Alzheimer's Disease                                           411-424                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                  X
Aphasia, paralysis after CVA                                  93; 186                                                                                                                                                                                                          X                               X                                                                                                                                                                              X
Arthritis                                                     165; 167; 175                                                                                                                                                                                                    X                               X                                                                                                                                                                                                 X
Cerebrovascular accident                                      186-187                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                  X
Chronic Illness                                               167-168                                                                                                                                                                                                          X                               X
Chronic Obstructive Pulmonary Disease (COPD)                  180-181                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                  X
Circulatory problems                                          183-187                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                                           X
Cognitive Impairment                                          186-187; 405-420                                                                                                                                                                                                 X                               X                                                                                                       X                                                                                         X
Common diseases and disorders including signs and symptoms.   chap. 11, 164-212                                                        X                                                                                                                                       X                               X                                                                                                                                                                                                                          X
Congestive Heart Failure                                      165; 183-184                                                                                                                                                                                                     X                               X                 X                                                                                                                                                            X                  X
                                                              92-93; 419; 392;
Depression                                                    394                                                                                                                                                                                                              X                               X                 X
Diabetes Mellitus                                             202-204; 430-432                                                                                                                                                                                                 X                               X                 X                                                                                     X                                                                      X                  X
Disorientation, Confusion                                     405-420                                                                                                                                                                                                          X                               X                                                                                                       X                                                                      X
Endocrine problems                                            202-204                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                                           X
Epilepsy                                                      408                                                                                                                                                                                                              X                               X                                                                                                                                                                              X                  X
Fractures                                                     176                                                                                                                                                                                                              X                               X                                                                                                                                                                                                 X
GI/GU problems                                                189-198                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                                           X
Loss of Sight/Hearing                                         204-207                                                                                                                                                                                                          X                               X                                                                                                                                                                              X
Mental retardation and dvelopmental disabilities              405-407                                                                                                                                                                                                                                          X                                                                                                                                                                              X
Multiple Sclerosis                                            199-200                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                  X
Musculoskeletal problems                                      174-176                                                                                                                                                                                                          X                               X                                                                                                                                                                              X                                           X
Myocardial Infarction                                         183-184; 368-369                                                                                                                                                                                                 X                               X                                                                                                                                                                              X                  X                        X
Nervous system conditions                                     198-200                                                                                                                                                                                                          X                               X                                                                                                       X                                                                      X                                           X
Organic brain syndrome
Parkinsons' Disease                                           200                                                                                                                                                                                                              X                               X                                                                                                                                                                              X                  X
Physical disabilities                                         408-409; 496-500                                                                                                                                                                                                                                 X                 X                                                                                     X
Respiratory disease                                           177-181                                                                                                                                                                                                          X                               X                                                                                                       X                                                  X                   X                                           X
                                                              172-179; chap.
Skin problems                                                 19, 354-361                                                                                                                                                                                                      X                               X                                                                                                                                                                                                                          X
Stroke                                                        186-187                                                                                                                                                                                                          X                                                                                                                                                                                          X                   X
Urinary tract infection                                       194                                                                                                                                                                                                                                                                                                                                                                                                                             X




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                                                      Wyoming
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               X                                       X
               X                                       X

                                                       X

               X                           X           X




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                                                      Wyoming
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               X




               X


                                                       X
                            X
               X
               X                           X
                                           X

                                           X




                            X




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               X




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               X            X              X

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               X            X              X           X
                            X




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                                                      Wyoming
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                                                      Wyoming
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                                          Wisconsin

                                                      Wyoming
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                            X              X
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                            X
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                                          Wisconsin

                                                      Wyoming
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                                          Wisconsin

                                                      Wyoming
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               X
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               X
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                          9/29/2013                             Page 66 of69
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                                          Wisconsin

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                          9/29/2013                             Page 67 of69
Basic nursing skills include:

hygiene
bedmaking
personal care of residents
food service
charting
infection control
basic preventative/restorative care
observation procedures (weighing & measuring)
communication skills
handing/caring for mentally confused residents
Orientation module contents:

handwashing
gloves
infection control
emergency procedures
Heimlich maneuver
resident's rights
abuse & neglect reporting
fire & accident safety
lifting
moving & ambulation
signal light answering
bedpan/urinal/commode/toilet
preparing residents for meals
serving meals
bathing
dressing & grooming
mouth care
bed making (occupied & unoccupied)
promoting resident's independence
communication & interpersonal skills

				
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