Certified Nurse Aide Requirements in Massachusetts

The Massachusetts Nurse Aide Registry is maintained by the Department of Public Health (DPH). Massachusetts Certified Nurse Aides are placed on the registry after meeting training and examination requirements.

Select a Massachusetts Certified Nurse Aide (CNA) Topic:

Training and Examination Eligibility

CNAs must pass state-approved programs. The most direct path is to complete a nurse aide training program. Massachusetts programs must be explicitly approved by the Massachusetts Department of Health.

There are alternate pathways to examination eligibility, though some apply only to those with work experience as health care aides. This is the case with individuals who trained as home health aides; in this case, the training must have been completed within the prior five years.

Individuals who completed 100 hour programs prior to July 1, 1989 can test. There is also an eligibility pathway for individuals who were employed in Massachusetts nursing homes on December 19, 1989 and can document that they had been in that same position for at least two years prior to that date. Although retraining is not required, the Red Cross notes that recent graduates have the most success on the examination.

Individuals who have completed at least 75 hours of clinical training in nursing school can test to become Certified Nurse Aides provided that the nursing school was one that qualifies its graduates to sit for national board examinations in Massachusetts.

Click here to learn about Nurse Assistant programs as well as additional entry to nursing and health care programs in Massachusetts.

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The Examination Process

Massachusetts CNAs take the Nurse Aide Competency Evaluation (NACE), administered by the American Red Cross (ARC). There are two components to the evaluation. The skills test involves scenarios; the candidate must act as a CNA and provide appropriate care. A candidate is expected to bring a person who can serve as an actor on the day of the test. This will need to be a person who will not be taking the NACE in the near future.

The knowledge test is multiple choice. Test takers have the option of selecting an oral examination and listening to the questions on CD.

Initially, the candidate will take both tests the same day. A candidate (or sponsoring facility) must pay $93 to cover the cost both the written and clinical test. The fee will be $103 if the oral version of the test is required.

Some candidates will test at their facilities. Those that do not will mark on the application which of the eleven Massachusetts Red Cross sites they are available to test at. Candidates are also expected to identify the dates they are unable to test and note them on the application. They can expect to be scheduled for examination within 26 days of the time the application is received. They should receive notification seven to ten days before the scheduled examination date.

A candidate who misses a test date can send a letter requesting rescheduling. The candidate will not have to pay the full testing fee. The American Red Cross will charge only $40 for the full evaluation (or $20 for an individual test). A candidate who allows a year to elapse, however, will need to submit a new application along with the full testing fee.

Test results will be sent out three weeks after the test.

Massachusetts candidates may make up to four attempts at the knowledge test and up to three attempts at the skills test. If the candidate fails both sections, another $93 will be assessed. A candidate who fails only the clinical test will pay $46. A candidate who fails only the written test will pay $47 (or $57 if the oral version is sought).

The American Red Cross has made a candidate guide available for download (http://www.redcross.org/images/MEDIA_CustomProductCatalog/m24321106_testing_application.pdf). The candidate guide provides details about the entire process. It also includes preparatory materials.

The Application Process

Candidates apply simultaneously for examination and for placement on the nurse aide registry. They may download their applications from the American Red Cross website (http://www.redcross.org/ma/boston/testing/).

Students who completed Massachusetts-approved CNA programs will include copies of their training certificates; a letter on letterhead can also be accepted if it includes required information such as approval number and date of completion.

Nursing school students may include a letter from the school or official transcripts. If the title listed on the transcript does not make it clear that the student completed the qualifying training, the transcript can be supplemented with a course description. The course description should confirm completion of 75 hours of clinical training.

A nurse aide applying on the basis of having been employed in a Massachusetts nursing home on the qualifying date (December 19, 1989) will need to submit a letter from the facility.

Some candidates will need to submit eligibility applications first to the Massachusetts Department of Public Health. This is the case with most individuals who must document qualifying experience in order to be approved for examination.

Eligibility applications can also be downloaded from the American Red Cross. The DPH will require information about the training program completed. An applicant who needs to confirm experience in a role such as nursing assistant or home health aide will need the signature of a supervisor.

Eligibility applications are to be mailed to the Division of Health Care Quality in Boston. Individuals who need DPH approval can expect to hear back within seven business days. If approved, they can apply to the American Red Cross for testing. They will include their approved eligibility applications.

Examination applications and supporting documents are to be mailed to the American Red Cross Testing Office in Peabody.

Applicants who have questions are invited to call (800) 962-4337.

Out-of-State CNAs

A CNA who received initial certification in another state and is active and in good standing can be granted direct reciprocity. It will not be necessary to pursue additional training or examination. Reciprocity applications are available on the American Red Cross website (http://www.redcross.org/ma/boston/testing).

CNAs are to complete the top section of the verification form, then mail it to the out-of-state registry. A list of out-of-state registries and phone numbers is found in the reciprocity application instructions. CNAs from the following states will mail their forms to the American Red Cross/Massachusetts Nurse Aide Program complete the verification process:

  • California
  • Colorado
  • Louisiana
  • Missouri
  • North Carolina

The Red Cross explains that these states do not handle reciprocity through paper form.

Individuals who are not currently active in any state but who completed CNA programs approved in other states will also need to complete eligibility applications and submit them to the Division of Health Care Quality. This must be done before applying for examination.

Additional Information

The Massachusetts Nurse Aide Registry Program (http://www.mass.gov/eohhs/gov/departments/dph/programs/hcq/nurse-aides/) can be reached at (617) 753-8144.

The American Red Cross Testing Office can be reached by telephone at (800) 962-4337 or (781) 979-4010. Individuals may also email ‘MATesting at redcross.org’.

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