(found 188 schools, updated in March 2017)
As required by law, North Carolina follows the terms of the federal Nursing Home Reform Act, referred to as OBRA ’87. This ensures that your training fully prepares you to offer a high quality of care to patients and residents in any type of healthcare facility. The following is a guide through the five major steps you must take to become certified and registered as a Certified Nurse Aide (CNA) in North Carolina.
Step 1: Choose the Right Path to Becoming a Nurse Aide I
Congratulations! You want to learn how to become a Nurse Aide I in NC. There are two levels of nurse aides in North Carolina: Nurse Aide I and Nurse Aide II. The first step is to become a Nurse Aide I by choosing a training and testing path that fits your situation and leads to CNA certification in North Carolina.
Paths to Success in North Carolina
The North Carolina Department of Health and Human Services (DHHS) maintains the NC Division of Health Service Regulation (DHSR). The Division is responsible for approving Nurse Aide I training programs and for maintaining the Health Care Personnel Registry. To work as a Nurse Aide I, you must be in good standing on the North Carolina Nurse Aide I Registry. That requires completing a Nurse Aide I training program and/or a competency evaluation program.
There are three possible paths to becoming a Certified Nurse Aide I in the state of North Carolina:
- Complete a state-approved Nurse Aide I training program and competency test.
- Obtain a training waiver and complete the Nurse Aide I competency test at a facility offering a state-approved program.
- If you are already an RN (Registered Nurse) or an LPN (Licensed Practical Nurse), you must meet the state licensing requirements.
Within these three paths are seven (7) routes you can choose between to become eligible to take the competency examination and apply to be placed on the NC Nurse Aide I Registry.
3 Routes Through CNA Training
You can take the state Nurse Aide I exam if you are eligible through one of the following routes:
- Route E1 – Candidates are eligible to take the state CNA exam after successfully completing a North Carolina state-approved Nurse Aide I program.
- Route E3 – Candidates are eligible to take the exam after completing a Nurse Aide I refresher course at a NC state-approved community college or proprietary school.
- Route E5 – Candidates that are currently enrolled in a NC-approved nursing education program to become a Registered Nurse or Licensed Practical Nurse can take the Nurse Aide I exam within two years of completing the NC-approved portion of the nursing education program.
The rules of the state CNA examination for candidates following Route E1, E3, and E5 are:
- You must pass both portions within two (2) years after completing a refresher course or within three (3) attempts.
- If you fail to pass the test within three attempts or do not take the exam within the two-year time period, you will have to complete the training program again and take both sections of the exam.
- If you fail to take and/or pass both exam sections within two years of training, and you change your eligibility route, then you are required to take both portions of the examination.
2 Routes Through Waiver
The following candidates must submit a Training Waiver request to the NC DHHS in order to take the state NA I exam:
- Route E8 – Emergency Medical Technicians or EMTs, nurses with expired or inactive Registry listings, military medics, and unlicensed nursing school graduates
- Route E9 – Individuals who was trained out of the state in the past 24 months but are not listed on another state’s registry
If you are eligible to take Route E8 or Route E9, you must take and pass both sections of the CNA state exam within two (2) years of the waiver approval date or within three (3) attempts. If you do not meet the requirements of passing both sections within three attempts or the two-year time frame, or you change your eligibility route, then you will have to complete a NC state-approved training program and retake both portions of the exam. Anyone who decides to change eligibility routes will have to take both portions of the examination.
1 Route for Certification Renewal
You can follow Route E10 to renew your CNA certification in North Carolina if your work requirements are not met for renewal:
- Submit a Training Waiver request to the DHHS
- If the waiver is approved, complete and pass the exam before the Registry expiration date within three (3) attempts.
- If you fail to pass both exam sections within the three attempts, you will have to complete training at an NA I training program approved by the state and retest.
- If you decide to change your eligibility route, you will have to take both portions of the CNA examination.
- If the Registry expiration date has passed, applicants will have to take a state-approved training program or complete a refresher program, and then test under route E1, E3, or E5.
1 Route for CNAs From Another State
Out-of-state candidates who are active on another state registry are eligible through Route E11:
- Complete testing before the out-of-state registry expiration date
- Submit a Training Waiver request to the NC DHHS
- Apply for testing within 45 days of the NC DHHS waiver approval date, or prior to Registry expiration, or within three (3) attempts, whichever comes first
- If you do not pass both portions of the NC exam as required, you will have to complete training at an NC state-approved training school and retake the state exam.
- You must take both parts of the NNAAP CNA examination if you change your eligibility route.
- If the Registry expiration date has passed, applicants will have to get training at an NC state-approved training program before taking the exam again.
Competency is proven by passing the National Nurse Aide Assessment Program (NNAAP) which was developed by the National Council of State Boards of Nursing, Inc. Pearson VUE is the state-authorized examination administrator in North Carolina. Pearson VUE offers both parts of the exam which includes a written examination and a skills evaluation. You can request an oral examination in lieu of a written examination, and it is offered in English or Spanish. You will need to pass both sections of the competency exam to qualify for applying to the NC Nurse Aide I Registry. In Step 3 of this guide, you will get more detailed information about the NNAAP examination in North Carolina.
Applicants for the North Carolina Nurse Aide I Competency Exam should be aware of a new rule that went into effect on March 1, 2016 (Rule 10A NCAC 130.0301). The new rule says that anyone interested in taking the exam must complete a state-approved training program before being eligible to register or schedule an examination through Pearson VUE. As you will also read in Step 2 on Nurse Aide I training, there are requirements as to when the training is completed, including a refresher course. It is important to know and understand the CNA certification requirements so you can get certified as quickly as possible.
Step 2: Take Nurse Aide I Training
Training to become a CNA in North Carolina is an educational process that teaches students how to complete certain CNA tasks as an employed Nurse Aide I. The curriculums may vary from program to program, but they all include a minimum level of instruction and hands-on skills training so you can deliver competent care to patients and residents.
Requirements to Enroll in Nurse Aide Training
To enroll in a CNA training program in North Carolina, you must be able to:
- Prove you are 17 years old or older
- Pass a drug test
- Produce a negative TB test
- Pass an FBI criminal background check
- Pass a health test showing you are physically fit and have no communicable diseases
- Produce proof of immunizations for Hepatitis B, varicella, TDaP, two-step PPD, and any others the program requires
Each school can add additional requirements to their program. For example, Wake Tech Community College requires students to have advanced English language skills. When you locate training programs of interest, the first thing you should do is call the school and get specific information on their requirements to sign up for a Certified Nurse Aide program.
188 State-Approved Programs
The most important tip to adhere to when searching for a training program is to only consider the North Carolina state-approved Certified Nurse Aide I programs. There is a list of 188 state-approved Nurse Aide I training programs on this site (updated in March 2017). The list is also available online at the North Carolina Department of Health and Human Services Division of Health Service Regulation (Health Care Personnel Education and Credentialing Section). These state-approved programs prepare you to earn CNA certification.
|Ahoskie||Hertford||Roanoke-Chowan Community College|
|Ahoskie||Hertford||Roanoke-Chowan Community College - Hertford County High School CCP|
|Ahoskie||Hertford||Roanoke-Chowan Community College - Northampton High School CCP|
|Albemarle||Stanly||Stanly Community College - CCP|
|Albemarle||Stanly||Stanly Community College - Crutchfield Education Center|
|Albemarle||Stanly||Stanly Community College - Main campus|
|Archdale||Randolph||Randolph Community College - Archdale Center|
|Asheboro||Randolph||Randolph Community College|
|Asheville||Buncombe||Asheville-Buncombe Technical Community College|
|Asheville||Buncombe||Asheville-Buncombe Technical Community College - Goodwill|
|Asheville||Buncombe||Asheville-Buncombe Technical Community College - Mission|
|Battleboro||Edgecombe||Edgecombe Community College - Incubator Site|
|Belmont||Gaston||Gaston College - East Campus|
|Biscoe||Montgomery||Montgomery Community College - CCP|
|Bolivia||Brunswick||Brunswick Community College|
|Boone||Watauga||Caldwell Community College and Technical Institute|
|Brevard||Transylvania||Blue Ridge Community College - Transylvania Center|
|Burgaw||Pender||Cape Fear Community College|
|Burgaw||Pender||Cape Fear Community College - Pender County High School CCP|
|Burlington||Alamance||Alamance Community College - Goodwill Site|
|Burnsville||Yancey||Mayland Community College|
|Butner||Granville||Central Regional Hospital|
|Castle Hayne||New Hanover||Caring for Life|
|Chapel Hill||Orange||Durham Technical Community College|
|Chapel Hill||Orange||Durham Technical Community College - Hybrid|
|Charlotte||Mecklenburg||American Academy of Healthcare, LLC|
|Charlotte||Mecklenburg||Carolinas College of Health Sciences|
|Charlotte||Mecklenburg||CarWil Learning Academy, LLC|
|Charlotte||Mecklenburg||Central Piedmont Community College - Central Campus|
|Charlotte||Mecklenburg||Chosen Health Care Institute, Inc.|
|Charlotte||Mecklenburg||Divine Health Academy|
|Charlotte||Mecklenburg||Serenity Nurse Aide Academy||(704) 567-8000|
|Charlotte||Mecklenburg||Umanah Healthcare Institute|
|Charlotte||Mecklenburg||Unity Nursing Institute||(704) 525-1448|
|Charlotte||Mecklenburg||Victory Health Career Center|
|Cherokee||Cherokee||Oconaluftee Job Corps|
|Clarkton||Bladen||Bladen Community College|
|Clayton||Johnston||Johnston Community College - Cleveland Campus|
|Clinton||Sampson||Sampson Community College|
|Clyde||Haywood||Haywood Community College|
|Columbus||Polk||Isothermal Community College|
|Concord||Cabarrus||Cabarrus College of Health Sciences|
|Concord||Cabarrus||Southern College of Health Sciences||(704) 707-3965|
|Conover||Catawba||Catawba Valley Community College - Goodwill Site|
|Creedmoor||Granville||Vance-Granville Community College|
|Denton||Davidson||Davidson County Community College - CCP (Career & College Promise)|
|Dobson||Surry||Surry Community College||(336) 386-3372|
|Dublin||Bladen||Bladen Community College|
|Durham||Durham||Durham Technical Community College|
|Durham||Durham||Durham Technical Community College - Hybrid|
|Durham||Durham||Gericare Education & Training, Inc.||(919) 479-3000|
|Durham||Durham||Harris Training Institute|
|Durham||Durham||Ideal Health Institute, Inc.|
|Durham||Durham||Wisdom Health Academy||(919) 323-3693|
|Edenton||Chowan||College of the Albemarle|
|Edenton||Chowan||College of the Albemarle - Chowan County High School CCP|
|Elizabeth City||Pasquotank||College of the Albemarle|
|Elizabeth City||Pasquotank||College of the Albemarle - Pasquotank County High School CCP|
|Elkin||Surry||Surry Community College - Elkin Center||(336) 386-3372|
|Enfield||Halifax||Halifax Community College|
|Fayetteville||Cumberland||Care One Health Training Institute|
|Fayetteville||Cumberland||Fayetteville Technical Community College|
|Fayetteville||Cumberland||Fayetteville Technical Community College - CCP|
|Fayetteville||Cumberland||Fayetteville Technical Community College - CDPK|
|Franklin||Macon||Southwestern Community College - Macon Center|
|Gastonia||Gaston||Apex Health Care Academy, LLC||(704) 396-6602|
|Gastonia||Gaston||Umanah Healthcare Institute|
|Goldsboro||Wayne||Wayne Community College|
|Graham||Alamance||Alamance Community College|
|Grantsboro||Pamlico||Pamlico Community College|
|Greensboro||Guilford||Guilford Technical Community College|
|Greensboro||Guilford||Mount Eagle College|
|Greenville||Pitt||Pitt Community College|
|Hamlet||Richmond||Richmond Community College|
|Hampstead||Pender||Cape Fear Community College - Alston Burk Center|
|Havelock||Craven||Craven Community College|
|Henderson||Vance||Vance-Granville Community College - Vance City Main Campus|
|Hendersonville||Henderson||Blue Ridge Community College - Health Science Center|
|Hickory||Catawba||Catawba Valley Community College|
|High Point||Guilford||Guilford Technical Community College|
|Hillsborough||Orange||Durham Technical Community College|
|Hudson||Caldwell||Caldwell Community College and Technical Institute|
|Jacksonville||Onslow||Caring for Life|
|Jacksonville||Onslow||Coastal Carolina Community College|
|Jamestown||Guilford||Guilford Technical Community College|
|Jefferson||Ashe||Wilkes Community College|
|Kannapolis||Cabarrus||Rowan-Cabarrus Community College - Research Campus|
|Kannapolis||Cabarrus||Rowan-Cabarrus Community College - West Avenue Center|
|Kenansville||Duplin||James Sprunt Community College|
|Kernersville||Forsyth||Forsyth Tech Community College - Grady Swisher Center|
|King||Forsyth||Forsyth Technical Community College - NW Forsyth Center|
|Kinston||Lenoir||Lenoir Community College|
|Kinston||Lenoir||Lenoir Community College - Lenoir County Off-campus Sites|
|Laurinburg||Scotland||Richmond Community College - Honeycutt Center|
|Lexington||Davidson||Davidson County Community College - CCP (Career & College Promise)|
|Lillington||Harnett||Central Carolina Community College|
|Locust||Stanly||Stanly Community College - Crutchfield Education Center|
|Louisburg||Franklin||Vance-Granville Community College - Franklin City Campus|
|Lumberton||Robeson||Robeson Community College|
|Manteo||Dare||College of the Albemarle - Dare County High School CCP|
|Manteo||Dare||College of the Albemarle - Roanoke Island Campus|
|Marble||Cherokee||Tri-County Community College - Technology Center||(828) 835-3095|
|Marion||Mcdowell||McDowell Technical Community College|
|Marshall||Madison||Asheville-Buncombe Technical Community College|
|Matthews||Mecklenburg||Central Piedmont Community College - Levine Campus|
|Mocksville||Davie||Davidson County Community College|
|Mocksville||Davie||Davidson County Community College - CCP (Career & College Promise)|
|Monroe||Union||South Piedmont Community College - OCH Campus|
|Monroe||Union||South Piedmont Community College - Sun Valley High School|
|Monroe||Union||Umanah Healthcare Institute|
|Mooresville||Iredell||Mitchell Community College|
|Morehead City||Carteret||Carteret Community College|
|Morganton||Burke||Western Piedmont Community College|
|New Bern||Craven||Craven Community College|
|Newland||Avery||Mayland Community College|
|Pembroke||Robeson||Robeson Community College|
|Pilot Mountain||Surry||Surry Community College - Pilot Center||(336) 386-8121|
|Pinehurst||Moore||Sandhills Community College|
|Pittsboro||Chatham||Central Carolina Community College|
|Polkton||Anson||South Piedmont Community College|
|Raeford||Hoke||Sandhills Community College - Hoke Center|
|Raleigh||Wake||Care One Health Training Institute, Inc.|
|Raleigh||Wake||Guiding Lights Nurse Aide I Program||(919) 371-2062|
|Raleigh||Wake||Wake Tech Community College|
|Raleigh||Wake||Wake Tech Community College - North Campus|
|Raleigh||Wake||Wake Tech Community College - PSEC|
|Raleigh||Wake||Wake Tech Community College - VMCCA|
|Randleman||Randolph||Randolph Community College|
|Reidsville||Rockingham||Rockingham Community College|
|Riegelwood||Bladen||Bladen Community College - East Arcadia|
|Robbinsville||Graham||Tri-County Community College||(828) 837-6810|
|Rocky Mount||Edgecombe||Edgecombe Community College|
|Rocky Mount||Edgecombe||Edgecombe Community College - OIC Campus|
|Rocky Mount||Edgecombe||Edgecombe Community College - Tarboro High School CCP|
|Rocky Mount||Nash||Nash Community College|
|Roxboro||Person||Piedmont Community College|
|Rutherfordton||Rutherford||Isothermal Community College|
|Salisbury||Rowan||Rowan-Cabarrus Community College - North Campus|
|Sanford||Lee||Central Carolina Community College - Wicker Center|
|Scotland Neck||Halifax||Halifax Community College|
|Sea Level||Carteret||Carteret Community College - Pruitt Health|
|Shelby||Cleveland||Cleveland Community College|
|Shelby||Cleveland||Cleveland Community College - Crest Site CCP|
|Siler City||Chatham||Central Carolina Community College|
|Smithfield||Johnston||Johnston Community College|
|Snow Hill||Greene||Lenoir Community College|
|Southern Pines||Moore||Sandhills Community College - St. Joseph of the Pines|
|Southport||Brunswick||Brunswick Community College - Southport Center|
|Sparta||Alleghany||Wilkes Community College|
|Spring Lake||Cumberland||Fayetteville Technical Community College|
|Spruce Pine||Mitchell||Mayland Community College|
|Statesville||Iredell||Mitchell Community College - Goodwill Center|
|Statesville||Iredell||Mitchell Community College - GW Site|
|Statesville||Iredell||Mitchell Community College - Housing Authority|
|Surf City||Pender||Cape Fear Community College - Pender County High School CCP|
|Sylva||Jackson||Southwestern Community College|
|Tarboro||Edgecombe||Edgecombe Community College|
|Taylorsville||Alexander||Catawba Valley Community College|
|Thomasville||Davidson||Davidson County Community College|
|Trenton||Jones||Lenoir Community College - Jones County Center|
|Troy||Montgomery||Montgomery Community College|
|Warrenton||Warren||Vance-Granville Community College - Warren County Campus|
|Washington||Beaufort||Beaufort County Community College|
|Weldon||Halifax||Halifax Community College|
|Wentworth||Rockingham||Rockingham Community College|
|West Jefferson||Ashe||Wilkes Community College - Ashe County High School|
|Whiteville||Columbus||Southeastern Community College|
|Wilkesboro||Wilkes||Wilkes Community College|
|Williamston||Martin||Martin Community College|
|Wilmington||New Hanover||Cape Fear Community College|
|Wilmington||New Hanover||Cape Fear Community College - New Hanover County High School|
|Wilson||Wilson||Fast Track Career Prep, Inc.|
|Wilson||Wilson||Wilson Community College|
|Windsor||Bertie||Martin Community College|
|Windsor||Bertie||Roanoke-Chowan Community College - Ashe County High School|
|Winston-Salem||Forsyth||Forsyth Tech Community College - Woodruff Center|
|Winston-Salem||Forsyth||Forsyth Technical Community College - Goodwill Center|
|Winston-Salem||Forsyth||Forsyth Technical Community College - West Campus|
|Winston-Salem||Forsyth||Mount Eagle College|
|Winterville||Pitt||Pitt Community College|
|Yadkinville||Yadkin||Surry Community College - Yadkin Center||(336) 386-3372|
|Yanceyville||Caswell||Piedmont Community College|
The various types of facilities offering Nurse Aide I training include:
- Community colleges
- Long-term care facilities
- Nonprofit sites (i.e. Goodwill)
- Training institutes
- Private training centers and institutes
- High schools
Since the age limit for CNA training programs is 17 years old, North Carolina allows high schools to offer CNA training programs that are managed by the North Carolina Department of Public Instruction (NCDPI). The high school-based programs meet the same strict training standards as programs offered in other facilities.
North Carolina schools of nursing can also offer students a certificate of completion for taking Nurse Aide I training while working on an RN or LPN degree. The North Carolina Board of Nursing (NCBON) assesses the Nurse Aide I component and notifies DSHR as to whether it meets Nurse Aide I training requirements. When the RN or LPN obtains the certificate of completion, it qualifies the person to apply for competency testing.
Some nursing homes also offer state-approved nurse aide training to employees. The nursing home has to be approved through the North Carolina Division of Health Service Regulation/Health Care Personnel Registry Section/Center for Aide Regulation Education (DHSR CARE).
CNA classes in North Carolina that are state-approved have gone through a credentialing process. The Division of Health Service Regulation’s Health Care Personnel Education and Credentialing Section approves these programs. The school or facility submits a Nurse Aide I Training Program Application Packet (DHHS/DHSR-4510 – Rev 2-2015) which provides the program details, including the clinical sites.
There are a number of forms that are submitted during the credentialing process, and one is the Faculty Approval Request Form for each faculty member. The Nurse Aide I Training Faculty Requirements Worksheet delineates the requirements for approval to teach a state-approved CNA I training program. Two important positions in a Nurse Aide I training faculty are Program Coordinator and Instructor.
According to the Worksheet, both a Program Coordinator and an Instructor must:
- Be a registered nurse with a valid license
- Be licensed to practice nursing in North Carolina
- Have at least two years of experience as a Registered Nurse in the U.S.
There are additional requirements for each of the two roles. A Program Coordinator must also have at least one year of RN experience in a long-term facility either working in the facility or supervising/teaching students in a skilled nursing facility. An instructor must also meet at least one of three conditions: completed a course in adult instruction, has experience teaching adults, or has experience supervising nurse aides.
The Nurse Aide I training program curriculum must meet the minimum requirements set by the state of North Carolina. The curriculum must consist of at least 75 hours of combined classroom, laboratory, and clinical instruction. A minimum of 16 hours of combined clinical and laboratory training must also be included in the 75 hours.
A state-approved curriculum covers the core content found in 23 modules. Each module represents knowledge in a particular area that Nurse Aide I students must know. The curriculum also meets federal requirements for those who will work in a federally certified long-term care facility.
The instructional modules are as follows:
- Module A: Nurse Aide I
- Module B: Infection Prevention
- Module C: The Resident’s Environment: Safety and Emergency
- Module D: Communication
- Module E: Law and Ethics
- Module F: Dignity
- Module G: Basic Restorative Care
- Module H: Body Systems
- Module I: Body Mechanics
- Module J: Nutrition and Fluids
- Module K: Restraint Elimination, Reduction, Appropriate Use
- Module L: Communicating with the Health Care Team
- Module M: The Nursing Process and Nursing Care Plan
- Module N: Incident Report
- Module O: Critical Thinking
- Module P: Family and Family Support
- Module Q: Person Centered Care
- Module R: Cognitive Changes Due to Aging
- Module S: Psychological Effects of Aging
- Module T: Dementia and Alzheimer’s Disease
- Module U: Mental Health and Mental Illness
- Module V: Pain
- Module W: End of Life Care
Laboratory and Clinical Training
Laboratory and clinical training has three components:
- Demonstration of skills by the instructor
- Student practice of the skills
- Proficiency check-off
Each student will perform a minimum of the 15 skills starred on the Performance Skills Checklists Summary in Appendix A of the “State-approved Curriculum Nurse Aide I Training Program” in a proficient manner under instructor supervision as part of their clinical training. These direct patient or resident care skills are performed after the student has demonstrated proficiency in the laboratory setting.
The starred skills include:
- Personal care – providing complete or partial bed bath, dressing and undressing, perineal care, making an occupied bed, foot care, fingernail care, mouth care for a conscious or unconscious person, and denture care
- Infection Prevention and Control – providing hand hygiene and putting on and taking off Personal Protective Equipment like gowns and masks
- Measurements – measuring and recording vital signs and measuring and recording height and weight
- Elimination – collecting urine specimens, assisting with bathroom use or elimination requiring bedpans or urinals, measuring and recording urinary output, providing catheter care, and emptying urinary drainage bags
- Hydration and nutrition – assisting with resident dining/feeding needs when they are unable to feed themselves and recording their intake
- Mobility – perform range of motion (ROM) exercises, transfer from bed to wheelchair or chair, position a person in bed, assist with ambulation, and apply restraints
- Treatment – Apply anti-embolism stockings
Length and Cost of the Program
The length of the Nurse Aide I or Nursing Assistant I course is 9 to 16 weeks, depending on how many times the class meets. Some schools offer different options.
For example, Durham Tech offers the following courses to become a nursing assistant:
- Traditional course – 16-week course requiring students to attend class twice a week to earn hours
- Fast Track course – 9-week course requiring students to attend classes Monday through Thursday to earn 179.5 hours
- Hybrid course – approximately 9-week course in which classroom work is completed online but onsite attendance is required one day a week is during the laboratory portion and two days a week during clinical training to earn 179.5 hours
- Fast Track and Hybrid course – approximately 9-week course in which classroom work is completed online but onsite attendance is required two days a week for the laboratory portion and Monday through Thursday for clinical training to earn 172.5 hours
- Hospital-based course – course covers the required NC Nurse Aide I state curriculum in the classroom and laboratory, but the clinical rotation is in an area hospital to earn a total of 172.5 hours. This course has special requirements beyond the traditional courses. Students must be 18-years old, pass a criminal background check and drug screening, and be certified in Basic Life Support by the American Heart Association.
The fee for each course is $254, but you must also buy the textbook, supplies, equipment, and a uniform for approximately $200. You also have to provide evidence of a negative TB test. Students must pass a criminal background check through FirstPoint and show proof of immunization to Hepatitis B or decline to receive the vaccine. Students can qualify for financial assistance.
This example gives you an idea of the type of options available for CNA training in North Carolina. In every case, CNA programs online will require physical attendance for laboratory and clinical training per state requirements.
CNA Refresher Courses
There are two groups of people who may need to take a CNA refresher course in order to get or remain on the registry.
- A Nurse Aide needs to refresh their skills before re-taking the competency exam. For example, you got a Training Waiver, but the registry expiration date has passed so you are required to complete a refresher course.
- EMTs, medical office assistants, and paramedics who need to master additional skills to pass the Nurse Aide I Competency Evaluation Exam, but do not need to repeat the training program, can also take a refresher course.
The refresher course for the nursing assistant is a basic review of the Nurse Aide I curriculum and the performance skills competency exam. It does not include clinical training.
Using Wake Tech Community College as an example, the refresher course costs $150. Payment may be made by check, money order, Visa, MasterCard, or cash. Classes are limited to 10 students. To be eligible to take the refresher course, you must be able to meet certain requirements:
- Your North Carolina Nurse Aide I Registry listing is expired and has no substantial findings, or
- You have successfully completed a NC Nurse Aide I program in the last five years, or
- You have a current Nurse Aide I listing from a different state with no substantial findings, or
- You have an expired out-of-state listing with no substantial findings from an accredited facility, or
- You have successfully completed a Nurse Aide I program in another state from an accredited institution within the last five years
Any North Carolina state-approved Nurse Aide I refresher course will have similar requirements.
Step 3: Pass the Exam
Pearson VUE administers the written (or oral) exam and the skills evaluation portions of the competency exam. You can apply to take the CNA exam if you meet one of the eligibility routes described in Step 1.
Applying for the Exam
Pearson VUE has an online registration process that requires creating an account. The account creation process creates an ID and assigns a password. It is important to accurately complete all the required fields which are asterisked.
Paying for the CNA Exam
You are required to schedule both parts of the exam (written and skills evaluation) the first time you test. The current fee schedule (subject to change) is as follows:
- Written examination and skills evaluation – $101
- Oral examination and skills evaluation in English or Spanish – $101
- Retest the written examination only – $24
- Retest the oral examination only in English or Spanish – $24
- Retest the skills evaluation only – $77
There are several payment methods accepted:
- American Express
- Electronic Voucher
Fees are non-refundable, so if you are unable to keep the appointed exam time, you will have to pay the required fees again when re-scheduling. The fees are also non-transferrable, meaning they cannot be applied to the new exam registration or used for any other purpose.
You are responsible for paying the fees unless you are working as a nurse aide in a nursing home that participates in Medicaid/Medicare programs. Per federal and state law, if there is a signed written commitment or employment agreement on file in a Medicaid-certified nursing home, the employer must pay the examination and re-test fees. If you are employed as a nurse aide by a Medicare/Medicaid facility within 12 months of passing both parts of the test, the facility may reimburse you for the cost of the test.
There are two types of testing locations: regional testing sites and in-facility testing sites. People with documented disabilities can request special accommodations.
Regional Testing Site
These are sites located in various locations around the state where anyone can test. A list of these sites is available on the NC Nurse Aide website and is accessible through Pearson VUE. You will register for a specific test date of your choosing based on the route you chose as explained in Step 1. The scheduling guide is located here.
In-facility Testing Site
The in-facility testing sites are only available to those who chose route E1, E3, or E5 in Step 1. The instructor will give you an INF code and a test date.
What to Bring to the Exam
It is important to arrive at least 30 minutes before the exams start. You need to bring a few items to the exam:
- Two forms of current identification with the following stipulations:
- It is official and signature-bearing
- Includes a U.S. government-issued social security card that is signed and not laminated
- Applicants in the armed services can use their U.S. Military I.D. instead of a social security card
- Second I.D. may be a non-expired driver’s license, state-issued identification card, passport, non-expired federally-issued Employment
- Authorization Document (EAD), or Alien registration card
- Three sharpened No. 2 pencils
- Watch with a second hand
Nothing else is permitted in the exam room, so do not bring any devices like a cell phone or beeper. Testing will begin on time. If you are late, there are no refunds.
What to Test
There are two parts to the North Carolina NNAAP test: a written (or oral) examination and a skills evaluation. These two parts are quite different because one is a multiple-choice exam and the other is a hands-on skills demonstration.
Written (Or Oral) Exam
This part of the CNA exam consists of 70 multiple-choice questions that must be completed in two (2) hours. The oral version is offered in English or Spanish and has 60 general multiple-choice questions and 10 multiple-choice questions that test your ability to speak a minimum amount of English, including commonly used nurse aide words.
Both exams test for knowledge of:
- Physical care skills – activities of daily living, basic nursing skills, and restorative skills
- Psychosocial care skills – emotional and mental health needs as well as spiritual and cultural needs
- Role of the Nurse Aide – communication, client rights, legal and ethical behavior, and member of the health care team
It is wise to review the practice exam of sample questions that Pearson VUE offers on its website or to find a longer test online. The more you practice, the easier the exam will be.
This part of the CNA test in NC is designed to test applicants as if they were in an actual caregiving situation. The test is administered by a Nurse Aide Evaluator, and all of the equipment is provided. Candidates volunteer to play the role of a patient/resident.
There are a number of skills that you may be asked to demonstrate, but some are called a “Critical Element Step”. Everyone must be able to perform these “Critical Element Step” skills, along with the other randomly selected skills, to pass the exam. The randomly selected skills will include a measurement skill.
The following is a list of 22 skills from which the exam demonstrations are pulled:
- Hand hygiene
- Help a patient or resident ambulate using a transfer belt
- Help a patient or resident use a bedpan
- Clean a full set of dentures
- Count and record respirations
- Measure and record blood pressure
- Put a knee-high elastic stocking on the resident
- Put on and remove personal protective clothing and equipment
- Count and record pulse
- Weigh resident who can self-assist and record results
- Dresses client with a weak arm
- Perform modified passive range of motion for the resident’s ankle and knee
- Help clients with feeding who are unable to eat or drink unassisted
- Give a modified bed bath
- Measure urinary output and record results
- Assist resident with modified passive range of motion for one shoulder
- Position on the side
- Deliver catheter care for a female
- Care for one foot
- Assist with mouth care
- Provide perineal care for female
- Help resident move from a bed to a wheelchair by using a transfer belt
Upon completion of the Nurse Aide I examination, the Nurse Aide Evaluator will fax the answer sheets for the written examination and the results of the skills evaluation to Pearson VUE. The official score results are available within ten (10) minutes. If you pass, you are on your way to certification. If you fail, you will have to re-test one or both parts, depending on your results.
Step 4: Get on the CNA Registry
Getting listed on the GA CNA Registry, and remaining listed, is required to continue working as a Nurse Aide I in North Carolina. It is up to the applicant to ensure all the information remains current and that all requirements are met for renewing the Registry listing.
CNA Certification and Registry in North Carolina
Once you pass both the written (or oral) examination and the skills evaluation of the NNAAP competency evaluation test, your name is sent to the State Nurse Aide I Registry. It takes approximately 2-5 days for your name to be listed, and it is free. Once your name is listed in the Registry as being in good standing, you are certified to work.
At any time you or an employer can verify the Registry listing either by calling 919-3969 or by going online. The site is updated regularly. Employers who check the site for verification of your status will get a confirmation number, proving a search was conducted to ensure employees have valid CNA certification. The Certified Nurse Aide Registry verification process is required by:
- Nursing homes hiring nurse aides
- Nursing homes hiring medication aides
- All health care facilities
A Nurse Aide I maintains active CNA Registry in North Carolina by working at least eight (8) hours as a paid nursing assistant every two years. Your duties must be those of a nurse aide which are the 22 skills listed previously. Your duties must also be supervised by a Registered Nurse.
The CNA renewal in NC process works as follows:
- Complete the scannable renewal form the Registry sends to nursing assistants three months before certification expires
- Report employment on the form
- Have the supervising RN sign the form, verifying the nurse aide performed the duties
- Send the renewal form to the Registry
- The Registry then renews the listing for 24 months from the last qualified work date reported on the form
You should take special note that the renewal date is from the last qualified work date and not the date you send the form in. For example, if you last worked a year ago, your renewal will be for 24 months but will expire in another year. Registry listings expire at the end of the month.
Lapsed Certification and Reciprocity
What happens if the certification lapses because you did not work at least eight paid hours of nurse aide duties, or you let your listing expire? You must take the North Carolina Nurse Aide I examination. Once you are registered to test, you must complete testing within two years of registration.
North Carolina does not have reciprocity and will not allow anyone to transfer their Nurse Aide listing from another state. The only way to get a NC Registry listing is to pass both parts of the competency exam.
Step 5: Work as a CNA
Once you get CNA certified, you can be fully employed in North Carolina. However, the supervising RN or LPN will validate your competence to perform specific duties. Your supervisor is also responsible for assigning you duties for the care of each patient and resident and for regularly monitoring the care you provide for the patients or residents.
Where to Work as a CNA in North Carolina
The Nurse Aide I can work in a variety of health care and long-term care facilities and provide in-home care. CNA jobs are found in:
- Specialty medical centers
- Rehabilitation centers
- Nursing homes
- Long-term care facilities
- Assisted living facilities
- Private companies, i.e. doing medical exams for insurance companies or providing home-based caregiving
- Private duty
- Employment services
CNA Duties and Skills
The skills that are included in the required training curriculum reflect the typical work duties of a Nurse Aide I. The specific tasks will all fall within the 22 skills categories discussed earlier. The North Carolina Board of Nursing groups Nurse Aide I tasks under six broad categories. They are personal care, body mechanics, nutrition, elimination, safety, and special procedures like taking vital signs and changing dressings.
The following are some of the specific duties you will be completing on a regular basis:
- Giving a complete or partial bed bath
- Dressing and undressing individuals
- Making an occupied bed
- Peri care
- Fingernail care
- Foot care, including skin and toenail care
- Mouth care, including the oral cavity, teeth, and dentures
- Handwashing per cleanliness standards
- Putting on and taking off personal protective equipment
- Measuring and recording vital signs
- Measuring and recording height and weight of ambulatory and bedridden people
- Collecting urine specimens
- Assisting patients or residents with using the bathroom, including measuring and recording urinary output
- Transferring people from a bed to a wheelchair
- Assisting with ambulation
- Positioning and repositioning the patient in bed
- Assisting with range of motion exercises
- Applying restraints
- Applying anti-embolism stockings
- Changing dressings
- Applying bandages
- Applying and removing an EKG monitor
- Postmortem care
Job Outlook for CNAs in North Carolina
Drawing from the U.S. Bureau of Labor Statistics, the Occupational Information Network (O*NET) reports the national job outlook for the 2014-2024 period indicates a 17% growth rate, which is must faster than average. In North Carolina, the most recent projections are for the 2012-2022 period, and the jobs are projected to grow by 27%, far exceeding the national trends. North Carolina anticipates 2,480 new job openings annually. | See Job Openings
Per the Bureau of Labor Statistics, there were 62,120 CNAs employed in NC as of May 2016. Greenville, NC is one of the nation’s top ten metropolitan areas with the highest concentration of CNA jobs. The Southeast Coastal North Carolina Nonmetropolitan Area and the Piedmont North Carolina Nonmetropolitan Area are both in the top five nonmetropolitan areas in the U.S. with the highest employment of Nursing Assistants. There are also many CNA jobs available around the state. | See Job Openings
CNA Salary in North Carolina
The U.S. Occupational Employment Statistics for May, 2016 say the national average annual wages for CNAs is $27,650, or $13.29 per hour. In North Carolina, the average annual salary is $23,630, or $11.36 per hour. Average annual wages around the state range from a high of $25,570, or $12.29 per hour in Durham-Chapel Hill, NC to a low of $20,180, or $9.70 in Northeast Coast North Carolina Nonmetropolitan area. For the state, the wages range from $17,410 at the 10th percentile to $30,710 at the 90th percentile. | See Job Openings
|NC CNA Salaries||Empl.||Hourly mean wage||Annual mean wage||Wage percent relative std. error||Hourly 10th % wage||Hourly median wage||Hourly 90th % wage||Annual 10th % wage||Annual median wage||Annual 90th % wage|
|Durham-Chapel Hill, NC||4870||12.29||25570||3.0||8.68||12.27||16.42||18060||25510||34150|
|Greensboro-High Point, NC||3910||11.35||23620||1.6||8.87||11.13||14.55||18450||23140||30260|
|Mountain North Carolina nonmetropolitan area||1900||11.14||23180||1.9||8.45||10.94||14.37||17570||22760||29890|
|New Bern, NC||510||10.99||22870||4.9||8.11||10.71||14.63||16860||22280||30430|
|Northeast Coastal North Carolina nonmetropolitan area||1660||9.70||20180||2.8||7.91||9.39||12.10||16440||19540||25160|
|Piedmont North Carolina nonmetropolitan area||5880||11.18||23250||2.1||8.23||11.21||14.29||17120||23320||29720|
|Rocky Mount, NC||1260||10.68||22210||2.3||8.14||10.47||14.25||16920||21780||29640|
|Southeast Coastal North Carolina nonmetropolitan area||6390||10.33||21490||4.1||7.90||9.55||13.94||16430||19870||28990|
Anyone who wants to find employment in the healthcare industry can get CNA certified in North Carolina in a short period of time. After a period of employment, many CNAs decide to continue their education and become an RN or an LPN. Being a CNA is a rewarding job that brings a higher quality of life to patients and residents and a personal satisfaction that comes from helping others in need.