Steps to Becoming a Certified Nurse Aide in Illinois

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Like every state, Illinois has specific requirements that must be met in order to work as a Certified Nurse Aide (CNA). These requirements are not as comprehensive as the requirements to become a nurse or LPN, making the CNA path an excellent way to enter the healthcare field before committing to a longer training program. CNAs have become instrumental in delivering high-quality patient care in a transforming healthcare delivery system. The following is a description of the five steps to becoming a Certified Nurse Aide in Illinois in 2017.

Step 1: Select a Path

The first step to becoming a Certified Nursing Assistant in Illinois is to choose the right path. The path chosen determines the amount of training and type of competency testing required.

Illinois Agencies and Terms

The Illinois Department of Public Health administers the CNA training and registration process. The Health Care Worker Registry (Registry) maintains the official status records of all Certified Nursing Assistants in the state. State-approved CNA training programs are called approved Basic Nursing Assistant Training Programs (BNATPs). The Illinois Nursing Assistant Training Competency Evaluation Program (NATCEP) is the recognized state CNA exam for testing the performance skills and knowledge of those who have completed the BNATP in IL. The CNA exam is composed of a manual skills and written competency test.

Six Paths to CNA Certification

Illinois offers six different paths to becoming a CNA, and each has its own unique requirements.

Path 1 – New Candidates

You can complete an Illinois-approved CNA training program and pass a written competency test.

Path 2 – Nursing Students or Graduates

You can complete a fundamentals of nursing arts course, which is normally part of the training program curriculum for becoming an RN or an LPN.

• If you are already licensed in Illinois as a Registered Nurse (RN) or Licensed Practical Nurse (LPN), and are in good standing, you can work as a CNA without being on the Illinois Registry.
• If your license is from another state, you must get on the Illinois CNA Registry before you are allowed to work.
• If your Illinois RN or LPN license is expired, you cannot work as an Illinois CNA until you are back on the Registry.
• Nursing students still completing their RN or LPN training can apply to become a CNA by providing written proof that a fundamentals of nursing course and at least 40 hours of supervised clinical training were completed at an accredited nursing program. You must also pass a written competency test.

Path 3 – Military Training

You have completed a U.S. military training program that is equivalent to a nurse aide training program. You must be able to provide documentation showing that you completed 40 hours of clinical experience or present Form DD 214 to prove you completed training as a hospital corpsman, medical service specialist, or other CNA equivalent training. If you are not a U.S. citizen, you must show proof of employment authorization to work in the U.S. You must also pass a written competency test.

Path 4 – Foreign LPNs or RNs

If you have completed a program and become an LPN or RN in another country, but do not have a U.S. nursing license, you can only work after getting on the Illinois CNA Registry. You must:

• Submit proof in English that the training program was completed
• Submit a copy of your official educational transcripts translated into English
• Submit a copy of your Social Security Card
• If you are not a U.S. citizen, submit official proof of employment authorization to work in the U.S.
• Pass a written competency test

Path 5 – CNAs Transferring From Another State

If you are listed, and in good standing, on another state’s CNA Registry, you must meet the following criteria:

• You are able to provide documentation of your current CNA registration from another state, and the documentation indicates the requirements listed in the Code of Federal Regulations (42 CFR, Sections 483.151 and 483.152) have been met. These are the regulations governing the state review and approval of nurse aide training and competency evaluation programs.
• You do not have an administrative finding of abuse, misappropriations of money, or neglect in any state’s CNA registry.

Path 6 – CNAs with Expired Certificates

When CNA certification in Illinois is lost due to a consecutive 24-month period without paid employment as a nursing assistant, you must be recertified. The recertification process in explained in Step 4.

If you need to complete a training program, there are state-approved CNA classes offered throughout Illinois. Larger cities have multiple schools offering CNA training. Step 2 provides detailed information about CNA training in Illinois.

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Step 2: Complete the Training

It is important to only attend an Illinois state-approved training program. There are hundreds of CNA programs around the state which are listed on the Illinois Department of Public Health (IDPH) website at here. At this time, the IDPH has not approved any online CNA programs, so you must attend an onsite training program. Depending on the location, programs are offered at colleges, technical institutes, high schools, training centers, academies, career centers, rehab centers, vocational centers, and nursing homes within the state.

278 Local CNA Training Classes in Illinois

School Enrollment Requirements

To enroll in a Certified Nursing Assistant program, you must:

• Be at least 16 years old
• Have completed a minimum of eight years of school or provide proof of equivalent knowledge
• Be able to pass a criminal background check
• Meet school entrance requirements
• Pass a health test which includes providing proof of immunizations and a negative TB test administered within the last six months

Learn 21 Performance Skills During Training

Students attend a Basic Nursing Assistant Training Program (BNATP) to learn the required CNA skills. There are 21 performance skills taught in every state-approved CNA training program. They are as follows:

Performance skills 2-21 are standalone skills, but there are beginning and completion tasks that are done before and after. For example, beginning tasks include washing hands, assembling equipment, introducing yourself, and explaining the procedure. Completion tasks include tasks like positioning the resident comfortably, conducting a safety check, washing hands, documenting activities, and returning the bed to an appropriate position. You will have to demonstrate that you have mastered these skills in order to qualify for CNA certification in Illinois.

Each of the 21 performance skills taught in Illinois CNA training programs has specific principles that must be followed. For example, for performance skill #2 – Perform Oral Hygiene the principles include positioning the resident, cleaning the oral cavity while using appropriate oral hygiene products, rinsing the oral cavity, cleaning and rinsing teeth and/or dentures, and cleaning and drying the mouth area. All Certified Nursing Assistant courses cover the principles within each skill.

Length and Curriculum Structure

The Illinois Department of Public Health requires that each program consist of at least 80 hours of lecture-based (theory) classroom instruction and 40 hours of clinical instruction. The CNA classes in Illinois must also include at least 12 hours of instruction that covers dementia.

The length of the program depends on the school or facility chosen, but most CNA programs take 3 weeks to 120 days to complete. The curriculum is usually one or two classes that include a series of lecture, lab, and clinical training times. For example, at Illinois Central College, the curriculum consists of two courses: HLTH 112 – Nursing Assistant Training and HLTH 116 – Nurse Assistant: Alzheimer’s.

At the Technology Center of DuPage, the Basic Nurse Assistant Training curriculum consists of a variety of topics that include the role of the nursing assistant, effective observation/communications, the 21 performance skills, human physical/emotional growth and development, body systems and functions, Alzheimer’s disease and related dementia, and common health problems and diseases. All curriculums include training in the 21 performance skills, but some can add additional topics. This course is six credit hours and is completed in one semester.

Fees

Students will pay a tuition or course fee for any CNA training program. The total cost of the CNA training program can range from $700 to $1,800, depending on the school selected for training. There are also likely to be other fees for:

• Uniforms
• Textbooks and Workbooks
• Supplies
• Health care equipment, like a thermometer and a transfer belt

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Step 3: Pass the Exam

To get on the Registry, you must pass the Nurse Aide Competency Exam. Anyone who attends and successfully complete a Basic Nursing Assistant Training Program (BNATP) in Illinois, or is approved for equivalency based on training defined in Section 300.663 of the Skilled Nursing and Intermediate Care Facilities Code (77 Illinois Administrative Code 300), can be competency tested. BNATP instructors are approved by the IDPH.

Nurse Aide Competency Evaluation Exam: Skills Test and Written Test

The Nurse Aide Competency Evaluation Exam consists of two parts: the performance skills evaluation (manual skills) and the written examination. There are a couple of paths available for taking the manual skills exam.

The Manual Skills Test

For students who complete a BNATP in Illinois, the manual skills, or performance skills, evaluation may be done in the classroom or a laboratory setting during the training program. For students attending facility-based programs, an Outside Approved Evaluator is employed to administer the manual skills test. For students who are approved for equivalency and are not taking BNATP, the performance skills evaluation will have to be scheduled. The state-approved evaluator can be found by contacting the registry or, in some cases, by contacting a community college.

The manual skills evaluation will select three skill sets from Group A and two skill sets from Group B. They are based on the 21 performance skills standards taught during training. The required 21 CNA skills are listed in Step 2.

The Written Test

The Southern Illinois University at Carbondale (SIU-C) is responsible for administering the written part of the Nurse Aide Competency Evaluation Exam through its Illinois Nurse Aide Testing division. The tests are offered at various sites throughout the state, and a list is available on SIU-C’s Illinois Nurse Aide Testing website. Exams are available throughout the year. After you take the exam, the results are electronically transmitted to the Illinois registry. The written exam is pass/fail. There is no published cut-off score.

Preparing for the Exam

SIU-C provides a sample test with CNA questions similar to those that will be asked on the Illinois Nurse Assistant/Aide Competency Examination. Taking the short, 10-question CNA practice test will give you a good idea of how the CNA questions on the real exam are structured.

It is also a good idea to review the 21 skills that the nurse aide typically performs on the job. Take a timed practice exam which your instructor may be able to provide, or you can find one online. Review wrong answers and the explanations of right answers to reinforce your learning.

The Process for Applying for Testing

After you complete the CNA training program and your instructor submits a roster to SIU-C with your name on it, you need to follow the process below to apply for a state CNA exam:

• Create an account with a login
• Register for an exam through SIU-C
• Indicate whether you will pay with a credit card or voucher
• Select the Illinois Nurse Aide Competency Test – Computer Version on the Products Screen
• Find an exam that meets your needs based on location, distance, and date
• Pay for the exam (the current fee is $65, but that can change over time)
• Receive a registration confirmation email

English

When 50% or more of a resident population at the facility where an applicant is working speaks another language, it is possible to ask for a translated exam. However, English as a second language is not considered a disability, so it does not qualify for special accommodations.

What to Bring to the Exam

SIU-C asks that students bring certain items to the exam:

• Picture identification which contains a signature and current photo, like an Illinois driver’s license or state I.D.
• Two number 2 lead pencils

What is Covered in the Exam

There has been extensive evaluation of 200 nurse aide tasks. The various tasks were validated in January, 2000 and grouped into six broad duty areas that reflect the 21 performance skills. The six areas covered on the Nurse Aide Competency Evaluation Exam are:

• Duty A – Communicating Information
• Duty B – Performing Basic Nursing Skills
• Duty C – Performing Personal Care Skills
• Duty D – Performing Basic Restorative Skills
• Duty E – Providing Mental Health and Social Service Needs
• Duty F – Proving Residents’ Rights

There are approximately 50-70 multiple choice questions on the written exam.

Getting Your Results

The written exam is now computerized, so it is delivered on a computer at the testing sites with the Respondus® Lockdown™ browser. You have 90 minutes to answer all the questions. The computer program will automatically score the test after 90 minutes. Once the results are verified, SIU-C will email your results within 2-3 weeks after the test is taken and will offer you a certificate of completion if you pass. Usually, you can learn whether you passed or failed the CNA exam about a week after taking it by checking the Health Care Worker Registry.

Retest

You are allowed three tries to pass the competency test. If you do not pass the CNA test after three attempts, you have to complete another Illinois-approved CNA training program before you will be allowed to take the written test again.

When Training is Disrupted for 24 Consecutive Months

Some people will also need to take and pass a manual skills test, depending on their circumstances. This includes any individual who has a disruption in their paid employment for 24 consecutive months as a Certified Nurse Aide, or Certified Nursing Assistant, and does not want to retake a CNA training program.

Federally-certified long-term care facilities have requirements stating that you must complete a new Illinois Nursing Assistant Training Competency Evaluation Program (NATCEP), or Competency Evaluation Program (CEP), after a 24-month work disruption. This is a requirement that ensures nursing assistants can provide the appropriate quality of care.

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Step 4: Get on the Illinois Registry

The Health Care Worker Registry is maintained by the Illinois Department of Public Health (IDPH) in Springfield, Illinois. Anyone can search the registry by name. The details provided include administrative findings, IDPH determination of the Illinois state police background check per the Health Care Worker Background Check Act, the last employment verification (active or inactive), programs completed, and competency. Employers can also use the Registry to verify if the social security number of a CNA is valid.

List on the Registry

Getting added to the Health Care Worker Registry for CNA certification in Illinois requires:

• Meeting training requirements
• Having an Illinois State Police (ISP) Criminal History Records Check recorded on the Health Care Worker Registry that does not show any disqualifying offenses or shows a waiver if there are disqualifying offenses; the background check is requested by the nursing assistant on form ISP 6-405B
• Demonstrating all 21 performance skills to an approved evaluator
• Taking the state written competency exam through SIU-C

The CNA registry in IL needs the following information before indicating a nursing assistant is active and in good standing on its website:

• Background check results
• Performance Skills Verification Form (Code 9996) completed by an approved evaluator
• Results of the written exam
• A completed application

The Nursing Student Application is sent to the Illinois Department of Public Health, Health Care Worker Registry. It gives the Registry permission to request fingerprint-based criminal history records. It also gives the Illinois State Police (ISP) permission to release information concerning any criminal record that may exist, necessary to meet certification requirements.

After the Illinois CNA Registry receives the application, it will send you a Livescan Request Form by mail. The request form should then be taken to a contracted Livescan vendor who collects the fingerprints.

If you have been convicted of a criminal offense in the past, it may be possible to get a waiver. Submit a Health Care Worker Waiver Application to the IDPH Health Care Worker Registry. The application asks some basic questions about the offense and offers the opportunity to provide additional relevant information that can help the IDPH decide if the waiver should be approved after conducting another criminal history records check.

CNA Recertification in Illinois

Recertification is a process for getting back into good standing on the Illinois CNA registry after it is lost due to failure to meet the work requirement. After getting on the Registry via any of the first five paths described earlier, you must not have a work break that exceeds 24 consecutive months. If there is a two-year break, during which you are not paid as a Certified Nurse Aide or to provide nursing-related services, you must go through the following recertification process:

• Take and pass a manual skills test: The test is administered by an Illinois approved evaluator who can be located by contacting the Illinois Registry or a community college. Another option is to complete an Illinois-approved CNA training program and then take the written competency test.
• Pass the background check requirements: An evaluator will mail a completed Manual Skills Evaluation Form to the Illinois Registry. The Registry verifies you passed the manual skills test, the background check, and that you do not have administrative findings. The Registry then mails you a form giving you permission to register for the competency test.
• Take and pass the written competency test: The written CNA test is administered by the Southern Illinois University at Carbondale (SIU-C).

No License Issued

Illinois is different than some other states in that Certified Nursing Assistants are not issued a license, credential, or card when active in the Registry. Renewal is not necessary because work is the basis for maintaining CNA certification in Illinois. Once you get certified, you remain certified as long as you continue working and do not have a disqualifying criminal offense.

It is the status in the Registry that proves the CNA is in good standing. That is one reason employers are required to verify CNA status in the Registry when hiring a new employee. The social security number serves as the certification number. Any letter or document that SIU-C issues is unofficial.

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Step 5: Work as a CNA in Illinois

The Illinois Nurse Aide performs a variety of tasks each day, and no two days are exactly alike. That is one of the interesting aspects of working as a healthcare professional with people who have different needs. It is a fulfilling career offering employment opportunities all over the state with salary growth through experience.

Where to Work as a CNA

A Certified Nurse Aide can work in a variety of health care and resident facilities. In fact, you can plan your career based on the type of facility and people you would like to assist. They are generally grouped as healthcare facilities, nursing homes, and assisted living facilities.

Healthcare Facilities

It may surprise you to learn about the full range of healthcare facilities in Illinois where you can work. The healthcare facilities include:

• Ambulatory surgical treatment centers
• Community mental health centers
• Hospitals
• Hospice facilities
• Outpatient rehabilitation centers
• Outpatient physical therapy/speech pathology centers
• Free standing emergency centers
• End stage renal dialysis
• Health maintenance organizations (HMOs)
• Pregnancy termination facilities
• Rural health centers
• Staffing agencies
• Nursing homes
• Assisted living facilities

Healthcare facilities that are not licensed long-term care facilities or federally certified long-term care facilities are governed by the Health Care Worker Background Check Act (225 ILCS 46). The Act applies to nurse aides, home health care aides, personal care assistants, private duty nurses, day training personnel, and anyone else providing similar duties or having access to long-term care residents.

To work in a healthcare facility, you have to be able to prove to the employer that you:

• Have met competency evaluation requirements
• Have no disqualifying convictions that have not been waived
• Have no administrative findings of neglect, abuse, or property misappropriation
• Are on the Illinois registry with active status

Employers are responsible for verifying that you are in good standing on the Registry. Remember that Illinois state law does not require training programs or the state to issue certificates or credentials once nursing assistant training is completed and/or the competency evaluation is completed. CNA certification is maintained through employment. You will lose certification if you experience 24 consecutive months without working as a paid CNA since completing the NATCEP or CEP.

Licensed Long-Term Care Facility

You must meet specific requirements if you want to work in a licensed long-term care facility. For example, if 75% of the facility’s residents speak Spanish, then you need to be able to speak and understand Spanish. This ensures you can communicate with the residents. Other requirements include:

• Not having disqualifying criminal convictions
• Being able to provide a criminal history records check
• Having no official finding of neglect, abuse, or misappropriated property in the state of Illinois or any other state
• Being at least 16 years old
• Having temperate habits, good moral character, being reliable, and honest
• Having the ability to speak and understand English or the language understood by a high percentage of facility residents
• Being able to provide evidence of prior employment and residence for at least two years before employment in the long-term care facility
• Having at least eight years of grade school education or providing proof of equivalency
• Meeting Registry requirements

The Illinois CNA requirements restrict CNA employment in a long-term care facility to those who:

• Are already a CNA when hired, or
• Are not a CNA when hired but work as a nurse aide in training and enter an approved CNA program within 45 days of starting work, or
• Are on the CNA registry within 120 days of starting work. If you are attending an approved CNA program, you have to be within 120 days of completing the program and competency test for certification. Proof of attendance at an approved program is required.

Federally-Certified Long-Term Care Facility

There are also specific requirements restricting CNA employment in a federally-certified long-term care facility. The following represents a mix of state and federal requirements:

• You must complete at least 16 hours of CNA classroom training in a state-approved training program before having any direct contact with a resident.
• Nursing assistant students can only perform the tasks for which they have been trained.
• Students can only provide services to residents while under the supervision of a Registered Nurse or Licensed Practical Nurse.
• You are limited to four months of full-time employment unless you have completed a state-approved Nurse Aide Training and Competency Evaluation Program (NATCEP) or Competency Evaluation Program (CEP).
• You need to have worked for 24 continuous months for compensation as a CNA since the last completion of the NATCEP or CEP; otherwise a new NATCEP or CEP must be completed.
• You can only be hired as a non-permanent employee if the NATCEP or CEP has not been completed.

In every case, the employer is required by state law to contact the Illinois Department of Public Health’s Health Care Worker Registry to verify the status of a nurse aide.

What to Do as a CNA in Illinois

The Certified Nurse Aide tasks may vary, but all revolve around helping patients or long-term care residents maintain a high quality of life through good hygiene and tracking of health status. Typically, a CNA performs the duties described below. These are the performance skills standards taught in state-approved training programs.

• Answer patient calls made with intercom systems, call signals, or signal lights
• Review patient dietary restrictions and ensure a proper diet is followed
• Assist patients with walking alone or with supportive devices
• Turn or reposition patients who are unable to get out of bed
• Cleanse and bathe individuals as necessary for patient health and welfare
• Take and record vital signs
• Monitor and measure fluid intake
• Report signs of patient distress, new symptoms, or other issues
• Assist patients with maintaining comfort and safety
• Assist patients with using the toilet
• Assist patients with light exercise when possible
• Collect biological specimens

The CNA uses various tools and technologies to complete their duties, including medical supplies, like blood pressure monitors and therapeutic equipment and assistive devices like wheelchairs and shower or bath chairs. This can be a physically demanding job because it requires regularly shifting patients or residents in bed or moving them from one location to another.

Job Outlook for CNAs in Illinois

Per the Bureau of Labor Statistics as of May 2016, Illinois had 60,090 employed nursing assistants. Long-term projections for the period from 2012-2022 indicate a 15.29% increase in positions, or 9,394 jobs, created as new jobs or jobs that become available as a result of turnover. The employment growth rate for the U.S. from 2014-2024 is projected to be 18%. | See Job Openings

As of May 2016 the Chicago-Naperville-Arlington Heights, IL Metropolitan Division has the third highest employment level for Certified Nursing Assistants in the USA. Kankakee, IL is number one on the list of top ten metropolitan areas with the highest concentration of CNA jobs. | See Job Openings

CNA Salary

Salary information from the Bureau of Labor Statistics, the Occupational Employment Statistics Program (a semi-annual survey by state) reports nursing assistants in Illinois currently earn a median salary rate of $25,420 compared to the U.S. rate of $26,590. The minimum CNA salary in Illinois is $20,290 and the maximum salary is $36,270. Where you work in the state of Illinois can make a difference in the amount earned. For example, the average annual salary rate as of May, 2016 for the East Central Nonmetropolitan Area was $23,270, but for Champaign-Urbana is was $26,760. The highest annual average wage is in Danville, IL at $34,610. | See Job Openings

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Conclusion

The requirements to become and remain a CNA in Illinois may seem complex, but they are intended to ensure patients and residents receive only the highest quality of care while in healthcare facilities or when receiving in-home services. Just follow the steps one by one, and the end result will be the successful addition of your name to the Illinois CNA Registry.