How to Start a CNA Training Program

Have you ever thought about starting a CNA training program? RNs are uniquely qualified to do so. Here's how. Nurses Nurse Beth Article

How to Start a CNA Training Program

Dear Nurse Beth,

I am RN-BSN for 12 years (Med/Surg), I am interested in starting a CNA program or Nurses Aide training school or program in my town ( Boston, MA ). What would you recommend or advise?

Dear Wants to Start CNA Training Program,

Congrats on your entrepreneurial spirit! Be prepared for set up costs and red tape but keep your eye on the long-term goal- a successful business. The guidelines below are specific to Massachusetts (MA) but each state has somewhat similar requirements.

For readers who are interested in starting a business in a different state, contact your state's Department of Health and Human Services (DHHS). They can provide the application.

Certified Nursing Assistants (CNAs) complete an approved training program and then take an exam. They are then certified (not licensed) and have ongoing CE requirements. For example, in CA, CNAs must complete 48 hours of CEs every two years.

Another option is to become an approved provider of CEs for CNAs in your state. It's a much faster and less expensive process. Approval is granted by the agency that certifies CNAs.

In some states, CNAs are used in acute care as well as skilled care. Training, both initial training and continuing education, is geared towards care of long-term residents.

Governing Agency

In (MA) the Department of Health and Human Services oversees CNA training and approved providers. Organizations seeking to offer Nurse Aide Training (NAT) programs in Massachusetts must obtain approval from the Department of Public Health's Nurse Aide Registry (DPH) and must be licensed by the Massachusetts Division of Professional Licensure (DPL).

To become a state-approved provider of a CNA training program, you will need to apply to

the MA Department of Health and Human Services. The application fee is $2,500. You will be scheduled for a site visit of your school/location as part of the approval process. Program approval is good for two years.

Program Requirements

As a nurse aide training provider, you must provide a minimum 100 hours of training to nurse aide students. The stipulated minimum contact hours includes 75 hours classroom training and no less than 16 hours of supervised practical training. Most programs offer four to six weeks of flexible training to accommodate varying schedules. You would need to have an arrangement with a local facility to provide clinical hours.

Didactic Content/Curriculum

By law, training prior to contact with residents must include (partial list):

Communication and interpersonal skills; infection control; safety/emergency procedures, including the Heimlich maneuver; promoting residents' independence; and respecting residents' rights.

Basic nursing skills; Taking and recording vital signs; measuring and recording height and weight; caring for the residents' environment.

Recognizing abnormal changes in body functioning and the importance of reporting such changes to a supervisor, and caring for residents when death is imminent.

Personal care skills, including, but not limited to- bathing; grooming, including mouth care; dressing; toileting; assisting with eating.

How to respond to resident behavior; allowing the resident to make personal choices, providing and reinforcing other behavior consistent with the resident's dignity; and using the resident's family as a source of emotional support.

Care of cognitively impaired residents:

Techniques for addressing the unique needs and behaviors of an individual with dementia (Alzheimer's and others); communicating with cognitively impaired residents; understanding the behavior of cognitively impaired residents; appropriate responses to the behavior of cognitively impaired residents; and methods of reducing the effects of cognitive impairments.

Basic restorative services: Training the resident in self care according to the resident's abilities; use of assistive devices in transferring, ambulation, eating, and dressing; maintenance of range of motion; proper turning and positioning in bed and chair; bowel and bladder training; and care and use of prosthetic and orthotic devices.

Residents' Rights. Providing privacy and maintenance of confidentiality

Instructor Qualifications

Qualified instructors must be a registered nurse with a minimum of 2 years of nursing experience, at least 1 year of which must be in the provision of long-term care facility services. Instructors must have completed a course in teaching adults or have experience in teaching adults or supervising nurse aides.

At the end of the training, students are eligible to take the state nurse aide competency evaluation.

Hope this helps you get started.

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

Career Columnist / Author

Nurse Beth is an Educator, Writer, Blogger and Subject Matter Expert who blogs about nursing career advice at

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Specializes in retired LTC.

I don't see this addressed but for OP, the program market for CNA training in the Boston area may already be saturated. It would behoove OP to thoroughly research the market before undertaking so much time, effort and finances for a strongly competitive endeavor.

My guess is that a metropolitan area such as Boston has enough NHs and other potential providers that would pose a challenge for a newcomer to the field.

Specializes in RN MPH CHES.

If this is the case, what are other options? How would they make their program unique? Maybe offering job placement for cna's who complete their program? I'm asking because I'm trying to do the same in my state of Maryland and it is also a saturated market.