5 Steps to Becoming a Certified Nurse Aide in New York State

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To become a Certified Nurse Aide in New York State in 2017, you must meet all of the requirements established by the New York State Department of Health (NYSDOH). Training must be completed at a state-approved facility. The examination is administered by Prometric. Upon passing the CNA state exam, your name is entered into the NYS Nurse Aide Registry as active and approved, and you are on your way to a great healthcare career.

Step 1: Choose One of the Six Paths to Becoming a CNA in New York

Learning how to become a CNA in New York State requires first understanding the different paths that can be taken to achieving certification. There are six paths in New York State (NYS) for an applicant.

Path 1: Not a CNA

This path is for anyone who is not a nurse aide:

• Complete a nursing home nurse aide training program that is NYS approved. To take the exam, the CNA training program must have been completed within 24 months of the application for examination
• Complete the New York Nurse Aide Application which is available online here
• Submit the application and fee to the training program coordinator or your employer
• Pass the exam within two years of completing nurse aide training

Path 2: A CNA From Another State

This path is for anyone who is already a nurse aide and listed on another state’s Nurse Aide Registry and wants to work in New York:

• Complete the New York Nurse Aide Application
• Attach a copy of your current nurse aide certificate from another state
• If the other state does not have expiration dates in its registry, you will need to submit proof that you worked at least seven hours as a nurse aide in the past 24 months. The letter has to be on facility letterhead and signed by your supervisor
• Pay the fees

Path 3: A Graduate Nurse and a Foreign-Trained Nurse

This path is for anyone who is a graduate nurse who was trained in the U.S. and anyone who is a foreign-trained nurse. It is necessary to pass the CNA exam in New York State with the following steps:

• Complete the New York Nurse Aide Application
• If a graduate was trained in the U.S., attach a copy of her or his nursing program diploma. If the applicant is a foreign-trained nurse, also attach a copy of your Social Security card, documentation of the courses you took in nursing school and a copy of an admission letter or some type of report of scores, if you have taken or plan on taking the New York State LPN or RN examination.
• Get application approval first from the NYSDOH NATP/NAR Program
• Once approved by the NYS NAR, submit the approved application with fees
• Pass the exam within 24 months of application submission.

Path 4: RN or LPN

This path is for anyone who is already a licensed, active RN or LPN. There are two steps for an LPN or a RN to become a Certified Nurse Aide in NYS:

• Complete the New York Nurse Aide Application
• Attach a copy of your current RN or LPN license

Path 5: A NYS-Trained CNA with Lapsed Certification

This path is for anyone who has lapsed certification but has completed a nursing home nurse aide training program at a NYS-approved facility on or after July 1, 1989. A certification lapses if you do not been paid as a nurse aide in the last 24 months at a NYS nursing home or approved facility. The applicant must take the following 3 steps:

• Complete the New York Nurse Aide Application, entering the NYS certification number
• Submit the application with fees
• Pass the exam within 24 months of application submission

Path 6: Other CNAs with Lapsed Certification

This path is for anyone who has lapsed certification, and the certification was obtained through Deeming, Reciprocity, Waiving or before July 1, 1989. The certified nursing assistant must take the following 3 steps:

• Take retraining
• Complete the New York Nurse Aide Application, entering the NYS number, and submit with fees
• Take and pass the exam

Additional Requirements to Get Certified in NYS

There are some additional requirements to earn CNA certification in New York State. To work in a nursing home or for a home care agency, you must pass a fingerprint-based criminal history record checks (CHRC), if you are a new unlicensed employee or an existing employee who begins providing direct care to residents. Since resident or client care is the primary duty of the CNA or facility-paid nurse aide trainee, all nurse aides must submit fingerprints to the Division of Criminal Justice Services (DCJS) and the FBI. The process for CNA certification is as follows:

• Employer submits fingerprints and fees to the NYSDOH
• NYSDOH submits fingerprints to the DCJS and FBI
• NYSDOH gets the results and sends letter to your employer and you indicating if you are eligible for continued employment

Criminal Convictions

There are certain criminal convictions that may disqualify you from getting certified, like a Class A felony and a Class B or C felony that occurred within the preceding 10 years. A full list is available in the Department of Health Regulations Title 10, NYCRR Part 402.

In the next step, you will complete required training at a facility you choose. However, it is critical that you only choose a state-approved program for training or retraining in order to qualify for CNA certification in New York State.

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Step 2: Complete a State-Approved CNA Training Program

Most people will have to complete CNA training at one of the nurse aide programs officially authorized by the state of New York. There are several government agencies approving nurse aid training programs:

• The Office of Professions at the New York State Education Department approves programs at community colleges, university nursing schools, Educational Opportunity Centers (EOD) and development centers.
• The Bureau of Proprietary School Supervision and Workforce Preparation at the New York State Education Department approves programs at vocational training centers, career centers, institutes, and technical schools.
• The New York State Department of Health also approves Nurse Aide Training Programs (NATP) at nursing homes.

134 State-Approved Certified Nurse Aide Classes in New York State

The following interactive table lists 134 state-approved CNA schools in New York State in 2017.

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State Mandated Curriculum

The “Guidelines for Approval of a Nurse Aide Training Program” clearly define the New York State Department of Health curriculum requirements. Approved curriculum meet state mandates and federal requirements for training nurse aides in residential health care facilities. The federal requirements per the Nursing Home Reform Law of the Omnibus Budget Reconciliation Act of 1987 (OBRA, PL 100-203) requires a two-part competency test – written and skills evaluation. The state mandated curriculum trains students in all the knowledge and skills they need to learn in order to deliver high quality patient care.

Types of Training Programs

There are two types of state-approved CNA training programs:

1. Secondary nurse aide training program – This training requires students to complete theory courses for a total of 324 hours. Of the 324 hours, 216 hours are for the core curriculum for a health occupations program, and 108 hours are courses in nurse assisting. The 108 hours of includes 30 hours of supervised clinical experience. This is an option for nursing students who also get CNA certification.
2. Adult nurse aide training program – This training requires 90 hours of classroom instruction plus 30 hours of supervised clinical training.

Nursing Students

Some nursing programs require students to also earn nurse aide certification. The nurse aide training is embedded in the program. After completing 90 hours of nursing theory courses and 30 hours of supervised clinical experience, the student is eligible to take the nurse aide exam.

Minimum Curriculum Requirements

The New York State Department of Health has established minimum curriculum requirements. Your training will include courses that cover:

Clinical Skills Training

Clinical skills training instructs students in a variety of nursing skills used on a daily basis for patient care. You will have to demonstrate minimum skills that include:

There are additional clinical skills that students will learn and demonstrate, like applying elastic stockings and assisting with the admitting of the resident. New York students will also learn about Indirect Care Behaviors which are concerned with the total quality of care a client receives. For example, an Indirect Behavior Is asking a resident about comfort while delivering care or asking about preferences before beginning care. In general, Indirect Care Behaviors are concerned with using standard precautions for infection control, and patient rights, comfort and safety.

Requirements to Enroll in a Nurse Aide Program

The minimum requirements to enroll in a nurse aide program are:

• Have a high school diploma or GED
• Be at least 18 years old
• Pass a criminal background check
• TABE (or equivalent test) minimum scores in reading and math
• Have an up-to-date immunization test
• Show a negative TB skin test
• Pass a physical exam

Some CNA schools may also require drug testing. If interested, there are schools that will allow you to take some CNA classes online, but all programs require completing clinical hours at a state-approved facility. On the average, CNA programs in New York last anywhere from five weeks to two months in New York.

Cost of the CNA Program

The cost of the nurse aide program can vary significantly, depending on the school chosen. In fact, the cost of nurse aide training in NYC alone can vary from school to school. For example, the Certified Nursing Assistant program in New York City is free to qualifying New York State residents who attend the Borough of Manhattan Community College. The City College of New York charges $1,199 for the Certified Nursing Assistant Certificate Program which is 33 sessions or two months long. Mohawk Valley Community College in Utica is a 120 hour course that is approximately five weeks long and costs $1,250. You can expect to pay $1,000 to $1,500 at most schools.

At many facilities, the uniform, textbooks, medical exam and competency evaluation exam fee are not included in the tuition. At Mohawk Valley Community College, the tuition does include the textbooks and the exam fee. When looking for a nurse aide program, it is important to research the total cost of the program and determine what the tuition does and does not include, especially if looking for a low cost option.

Financial Aid

There is financial aid assistance available. Some of the schools offer program discounts or financial aid to keep the program costs affordable. You can also apply for a New York State Workforce 1 Individual Training Grant that will fund tuition, testing fees, textbooks, and registration fees. It does have education and minimum work experience requirements.

One other option is to work as a CNA trainee at a long-term care facility, like The Wesley Community, and get the training class free. The classroom and clinical training are held in Hudson Falls and once the class is completed, you are offered full or part-time employment. You pay for uniforms and shoes, but the facility pays for the training class in full.

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Step 3: Pass the Exam

To get certified after completing a nurse aid program, you must take and pass the New York State Competency Examination for the Nursing Home Nurse Aide. After passing the CNA exam, your name is entered into the New York State’s Department of Health Nurse Aide Registry.

Application Process

The Competency Exam is scheduled through Prometric. There are two parts. One part is the Written/Oral exam and the second part is the Clinical Skills exam.

The application process is as follows:

• Submit the application form to the NYS Nursing Home Nurse Aide Registry (NYS NAR). The application can also be obtained at your school or nursing home training program.
• Submit the application with fees to the appropriate facility or agency

Fees and Payment

The 2017 fees are currently set as follows but can be changes:

• Written and Clinical Skills Exams when taking test for first time: $115
• Clinical Skills and Oral exams: $135
• Retest for Clinical Skills: $68
• Retest the Written Exam: $57
• Retest the Oral Exam: $67
• Application processing for Reciprocity/CNA: $50
• Recertification: $40

You pay fees to the NYS Commissioner of Health, NYNA. Only certified checks, money orders and 3rd party/facility checks are acceptable payment forms to Prometric.

Employment in a Nursing Home

If you are already working in a nursing home, the exam fee must be paid by the employer per federal law. This may be paid up front by the employer, or you are entitled to a refund if you personally pay the fees.

If you get a CNA job in a nursing home within 12 months of completing your training or passing the exam, New York State will pay a portion of the training costs and/or the exam fee. Be sure to keep your receipts. Give them to the nursing home, and the facility will submit the reimbursement paperwork.

Testing Locations

There are many CNA testing sites around the state of New York. The exam can be taken at the training program facility, a long-term care facility or a Prometric regional exam site.

In-Facility

If you plan on taking the test in-facility, someone from the training program or long-term care facility will schedule the time and date of the CNA exam. If you are already working at the nursing home, the facility will send the fees in. If you are taking the CNA test at your school or institute, you will have to pay the fees when your school is ready to send the application to Prometric.

Regional Exam Site

Sometimes, it is more feasible or convenient to take the CNA test in New York at a regional exam site. Maybe you moved or got a job after completing training. You send the application form and fees to Prometric with the correct city name on the form. Prometric then schedules the state exam.

After Your Application

After the application is approved, you will receive a confirmation letter via email that indicates the date, time and location of the CNA state exam. If the application is incomplete, you will be informed. If you are testing at a regional exam site, you must bring the confirmation letter with you. The regional exam sites are listed here.

Applicants are allowed to reschedule for up to five business days before the exam date. After five days, the fees are forfeited, so you will have to pay the fees again in order to reschedule. If you took an in-facility exam, you should contact the facility to reschedule your CNA exam. If you took a re-exam at a regional test site, you should contact Prometric.

What to Bring to the CNA Certification Exam

The items you are allowed to bring to the certification exam are very limited:

• Two pieces of ID – The first ID must be an office government, employment or school ID that has a current photo and your signature. The second ID can be a signature ID like a Social Security card or credit card.
• Admission Letter –This is the Prometric approval letter you receive if taking the exam at a regional exam site.
• Watch – The watch must have a second hand.

You can bring lunch and nonalcoholic beverages to eat outside the exam room while waiting for an exam to start. If you need any assistive devices, it is important to ask for approval when applying for the state exam and not wait until exam day.

What to Test

The Written/Oral exam consists of 60 multiple-choice questions. The Clinical Skills exam is a hands-on demonstration of five skills selected from the list provided in the Step 2. You must pass both parts within three tries, or you will be required to retake the entire exam. You also have two years after successfully completing your nursing aide training program to pass both parts of the exam in New York State.

Written Exam

You get 90 minutes to answer 60 multiple-choice questions. Prometric offers a content outline on its website. However, the questions that are asked on the test come from the courses you take during certified nursing assistant training. The subjects of the questions are the same ones that are listed in the Step 2, i.e. safety, resident rights, health maintenance, resident care, etc. A Nurse Aide Practice Exam is available at www.prometric.com/nurseaide which gives immediate feedback on your answers. There is a $10 fee for a CNA practice exam, and a $25 fee for three practice exams. These are excellent for testing your knowledge and highlighting areas where you may be weak.

Oral Version of the Written Exam

Many schools require a reading and comprehension English skill level for admittance. If you have a reading disability or your reading skills are marginal, an Oral exam is more suitable to you. You request the Oral exam on the application form. The Oral Exam is longer than the Written Exam because there are CNA skills questions asked by playing a CD that are similar to the Written Exam and another set of 16 questions to test Reading Comprehension. You get an extra 30 minutes to complete the Reading Comprehension test and must pass it to pass the Oral Exam.

Clinical Skills Exam

The clinical skills you must demonstrate to a Nurse Aide Evaluator during the timed exam are randomly selected from the skills listing in the Step 2. You complete three skills but five skills are scored. The additional two skills are Indirect Care (described in the Step 2) and Handwashing. The Clinical Skills Exam takes 31 to 40 minutes to complete. An in-depth Clinical Skills Test Checklist is provided here.

Getting Results and Retesting

The CNA certification exam results are sent to the New York State Department of Health (NYSDOH) and the training program or nursing home. If the Written (or Oral exams) and the Clinical Skills exam are passed, you are sent a New York State Nursing Home Nurse Aide Certificate and a card you can carry in a wallet. Within 10 days after passing the exam, your certificate will arrive and your name will appear in the registry.

If you fail the Written (or Oral exam) and/or the Clinical Skills exam, an official score report is sent by email within five business days after taking the CNA state exams. The report offers feedback so you know the areas where you are weak.

You are allowed to retest each section three times within a two year period from which you completed your CNA training program. This requires re-registering to retest, meaning you go through the application process again. If you do not pass both exams within the allotted timeframe, you will need to complete the CNA training program again.

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Step 4: Getting on the Registry

After passing the Competency Evaluation exams and earning CNA certification, you are listed in the NYS Nurse Aide Registry. Your name and information will usually appear in the registry a few days before you get your certificate via email.

Registry and Verification

Prometric maintains the CNA registry in New York State. It is used by the state, employers and nursing homes to verify that a CNA has met all state requirements to be in good standing. In fact, nursing homes are required by law to verify the CNA’s status. The listings includes name, contact information and any convictions or sustained findings involving abuse, mistreatment or neglect of residents.

CNA Renewal

Your CNA certification in New York is good for two years or 24 months from the date of your last certification. The state will mail a reminder to your home address approximately 45 days before you need to renew your registry listing.

The process and requirements for CNA renewal in New York include:

• You work as a nurse aide with a New York State Department of Health-approved nurse aide employer or nursing home for a minimum of seven hours within the prior two-year period. Eligible employers include all New York State licensed Residential Health Care Facilities, other facilities as long as the NYSDOH has approved them, and employment or staffing agencies.
• The employer recertifies you as having met the employment requirement and will pay the CNA recertification fee.
• If you are working at the time of the renewal, you are certified for two years beginning on the last day of the month in which the current certification expires.
• If you are not working at the time of the renewal, the recertification beginning date is moved to the last day you worked as a nurse aide.
• You get a new certificate and wallet card in the mail.

Certification by Reciprocity

If your original certification was obtained through approved reciprocity (Path 2 in Step 1), you will need to make sure you can prove you have worked at least seven hours in the last two years in a state-approved facility in order to renew your CNA certification in New York.

Certification Verification

The registry is accessible 24-7 for CNA verification in NY. Anyone can call 800-918-8818 and use the interactive voice response registry to get verbal or written verification. However, the caller needs the Nurse Aide certification number to access the information. The registry can also be accessed online by visiting https://registry.prometric.com/public.

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Step 5: Work as a CNA in New York State

The Certified Nurse Aide has a varied job because no two residents or patients have the same needs. However, once the nursing assistant knowledge and skills are mastered, CNAs are transferrable from job-to-job and state-to-state. This is the result of the federally mandated curriculum used by the states. | See Job Openings

Where to Work

CNAs can work in a variety of facilities. However, remember the facility must be approved by the New York State Department of Health in order to get employment credit for recertification. The NYSDOH licenses:

• Adult care facilities
• Assisted living facilities
• Clinics
• Diagnostic and Treatment Centers
• Emergency Medical Services
• Hospice
• Hospitals
• Long-term care facilities
• Nursing homes
• Palliative care facilities

The CNA works under the supervision of a Registered Nurse (RN) or Licensed Practical Nurse (LPN). Becoming a certified nurse aide is often a first step for people who want a career in healthcare. For example, a nurse aide can add certification as a home health aide with the proper training provided by a training program or facility. Or the CNA could return to school to pursue one of the other nursing careers as a LPN or RN. | See Job Openings

Job Duties of the CNA

The courses and clinical training you complete, outlined in the Step 2, cover the CNA skills that you need to know in order to provide a variety of patient and resident services. On a work shift, you will perform CNA duties like:

• Collect specimens from patients for medical analysis
• Take and record the height, weight, blood pressure, temperature and other patient or resident vitals
• Report symptoms and signs of disease to medical personnel
• Assist residents with personal care, like bathing, cleaning teeth or dentures, hair and the body in general
• Maintain a clean and safe area for patients or residents
• Assist clients with getting in and out of bed, using the toilet or bedpan, light exercise and other needs
• Assist clients with dressing
• Help residents reach other areas like common areas for meals or entertainment rooms for socializing
• Feed or help feed residents and patients
• Position or reposition patients in beds
• Assist with keeping patient safe

Read through the list of course topics and clinical skills in the Step 2, and you will have a good idea of what the CNA job entails. | See Job Openings

Job Outlook for CNAs in New York State

The State of New York claims the highest number of employed CNAs in the U.S. As of May 2016, approximately 98,040 people were working as nurse aides in the state. The job outlook is very good. There are always hundreds of available CNA jobs in NYC alone. New York-Jersey City-White Plains, NY-NJ Metropolitan Division has the highest employment level for a metropolitan area in the nation with 70,790 nurse aides last May 2016 or almost 73 percent of all the employed nurse aides in the state. The projected growth in employment in New York State for 2012-2022 is 14 percent, compared to 18 percent nationally for the period 2014 to 2014. | See Job Openings

Healthcare Salaries Comparison

The average annual CNA salary in New York was $34,300 as of May 2016 per the federal Bureau of Labor Statistics. How does that compare to other healthcare professions? The average annual salary for Licensed Practical Nurses (LPN) in New York was $47,170 annually as of May 2016. For Medical Assistants, the May 2016 average annual salary in New York was $35,530. Home Health Aides earned $24,150 in New York State for the same time period. Nationally, Certified Nursing Assistants (also called Certified Nurse Aides) earned an average annual wage of $27,650. | See Job Openings

Top Paying Regions for CNAs

It does make a difference to the nurse aide salary where you work in New York State. The average annual nurse aide salaries range from a high of $38,740 to a low of $26,880. The top five paying areas in New York State are:

• Nassau County-Suffolk County, NY Metropolitan Division: $38,740
• New York-Jersey City-White Plains, NY-NJ Metropolitan Division: $34,910
• New York-Newark-Jersey City, NY-NJ-PA: $34,550
• Dutchess County-Putnam County, NY Metropolitan Division: $32,970
• Elmira, NY: $31,840

CNA Salaries in New York

Providing quality services to people who are sick, injured, aging or dying is a fulfilling career. CNAs improve the quality of life for a variety of people and can enjoy the respect of other healthcare professions.