What is a "CNA"?
A "CNA" is a term used to describe a Certified Nursing Assistant or Certified Nursing Aide. The CNA is an important member of a healthcare team who provides basic patient care and assistance with daily activities, such as bathing, dressing, eating, rehabilitation, observation, and reporting of changes in condition. CNAs work under the supervision of licensed nursing staff and other medical providers, such as doctors or administrators. While CNAs are not nurses, they work closely with them as essential members of the team by providing most of the direct hands-on care and support to reduce workloads and improve the quality and efficiency of patient care in hospitals, clinics, assisted living facilities, hospices, patient homes and many other locations.
Is there demand for CNAs?
Yes, there is a large demand for CNAs in Iowa and across the nation. In fact, the position is usually in the Top 5 for highest demand here in Iowa. The position serves as a great entry point for those looking to work in healthcare. The career pathways for a CNA are almost limitless, with new opportunities being created with expanding technologies and changing patient care demands.
How much money does a CNA make?
Although wages and benefits are going to vary greatly between employers, work environments and assigned duties, on average CNAs in Iowa can expect to be paid around $15-$25 an hour, or $31,200-$52,000 per year. It is important to keep in mind that CNA is an entry-level position and many CNAs that show passion and a desire to learn are often promoted to more advanced roles rather quickly in nursing, administration and other health or human services areas. It is also important to remember that CNAs make more than money, they make a real difference in the lives of their patients and community members they serve every day. Visit https://www.onetonline.org/link/localwages/31-1131.00?st=IA to review current wages for CNAs in Iowa.
How do I get "licensed" as a CNA in Iowa?
There is no CNA license. Upon successful completion of a state-approved CNA course, individuals receive a course completion certificate to become a "Certified" Nursing Assistant/Aide. This certification does not expire and there are currently no continuing education requirements for this certification.
What are the state-approved CNA courses and how do I sign up?
Iowa's community colleges offer state-approved training for individuals interested in becoming CNAs. The colleges offer both classroom studies and hands-on clinical training. Some health care facilities and other private entities also offer training for individuals interested in becoming CNAs. A list of approved programs and locations can be found at https://dial.iowa.gov/how-do-i-cna-training.
Where are clinical hours completed and do I have to find a location myself?
Students will be placed by a community college in a nursing home setting that meets state requirements to complete their clinical work hour requirements. Students are not required to find locations themselves.
Do I have to take a state-approved CNA class to work as a Nursing Assistant/Aide?
Only those individuals who have completed a state-approved CNA course can be considered a CNA. Some health care providers, facilities or other related employers will only hire CNAs, but others may be willing to hire a non-certified Nursing Assistant/Aide (NA). The role of a non-certified nursing assistant may be referred to by that employer using job titles such as a patient care assistant, patient care technician, nursing assistant or other variations of those titles. An NA is someone who has not completed a state-approved CNA course, but who has either challenged the state CNA exam or who has received on-the-job training specific for the NA role.
What is the "Registry"?
The Iowa Direct Care Worker "Registry" is a database of individuals who have both passed both a Skills and Written Exam (also called Registry Exams or OBRA testing) making them eligible to work in a Long-Term Care (LTC) facility as a nursing assistant/aide. It is a federal requirement that nursing assistants/aides must be on the Registry to work in an LTC Facility, which includes nursing home, skilled nursing facilities or a skilled or swing bed unit of a hospital. Here in Iowa, the Department of Inspections, Appeals & Licensing (DIAL) oversees the Registry. There are no state of federal requirements for a CNA to be on the registry to work anywhere except LTC. While many hospitals, assisted living facilities, hospices and other settings may prefer to hire CNAs, they are not required to be on the Registry.
Where can I complete the Registry skills and written exams?
The skills and written exams must be taken at one of Iowa's community colleges. Students are able to test at any community college, regardless of student residence location or where courses were taken. Students are encouraged to explore testing locations that offer the most desirable dates and times. The cost for testing is the same at all locations.
Registry testing can also be completed at any time. Students do not need to wait until the end of their CNA course to both schedule and test. Both exams must be passed to be added to the Registry. If an individual passes only one exam, they have one year to pass the other exam or both exams will have to be repeated.
How do I check my status on the Registry?
Individuals may visit the Health Facilities website to see if they are currently active on the registry. Select "DCW Search" on the left side of the page, and search by Registry ID number, first or last name, city, or county.
How do I stay on the Registry?
To maintain active status on the Registry, you must work as an employee and complete at least one day of nursing or nursing-related duties every two years.
Are there any Continuing Education (CE) requirements?
No, there are no continuing education (CE) requirements to remain on the Registry. LTC facilities, however, are required to provide and their CNA staff are required to complete at least 12 hours of in-service training per year for the facility to maintain their license.
How do my work hours get reported to the Registry so that I may stay "active" on the Registry?
All LTC facilities and Healthcare Employment Agencies who may work in LTC are required by state and federal law to report your qualifying employment to the Registry.
What if I work somewhere else? Can that count to keep me active on the Registry?
Hospices, hospitals, home health care agencies (HHAs), and ambulatory surgical centers (ASCs) may, but are not required to, report CNA's qualifying work hours if the work done by the CNA includes typical CNA nursing duties. If these entities chose to report CNA work hours to the Registry, they may do so electronically.
If a CNA performs typical CNA nursing duties at a different type of facility, that facility may report those hours for consideration to keep the CNA active on the Registry. If they chose to submit the CNA's hours it cannot be done electronically, they must do so "manually" by providing DIAL with a job description for the CNA and a letter on facility letterhead showing the CNA has completed at least one day of paid, nursing or nursing-related duties. The employer must provide enough details to show that the CNA has met the long-term care employment guidelines. DIAL will make the determination if this work qualifies to keep the CNA active on the Registry.
Can I report work hours myself?
No, a CNA cannot report their own hours to the Registry, nor can the CNA provide a letter verifying employment from the employer to DIAL directly.
Can my hours be reported after I have fallen off the Registry?
If the hours were worked while the CNA was still "Active" then yes, the employer may report the hours late, but these hours must be reported manually and may require assistance from a DIAL staff member.
How do I get back to "Active" status on the registry if I have expired or fallen off?
Individuals will have to retake and pass both of the skills and written exams through any Iowa community college to become active on the Registry.
Is there a class I can take to help me prepare to retake Registry exams?
Only individuals who have successfully completed a state-approved CNA course, and are thus "certified" CNAs, may enroll through one of the community colleges for the "CNA Refresher Course". Individuals who challenged Registry exams to get onto the Registry (a.k.a. Nursing Assistants/Aides or NAs) are not eligible to take the CNA Refresher Course but would instead need to complete a full-length state-approved CNA course.
What if I have lost the copy of my CNA certificate I received after taking a state-approved CNA course?
Contact the community college where you took your CNA course to discuss options. There may be a charge for a duplicate certificate.
How do I get a Registry card?
Registry cards are no longer mailed by DIAL. Cards can be securely printed from the Iowa Direct Care Worker database, by either CNAs or Iowa facilities who are logged in with an account ID and password. More information can be found here.
Is there any funding available to cover the cost to become a CNA?
Yes, there is often funding available through different sources to help students cover the cost to become a CNA, or to enter into healthcare in general. The admissions or healthcare education staff at each community college will assist students in navigating these sources, such as the Future Ready Iowa Last Dollar Scholarship.
Iowa Code 81.16(3)c(1) requires that a nurse aide who is employed by, or who has received an offer of employment from a LTC facility on the date on which the student begins nurse aide training or completes Registry exams, may not be charged for any portion of the program including any fees for textbooks, course materials or registry exams. These must be paid by the LTC employer.
Iowa Code 81.16(3)c(2) also requires that if a person paid for their nurse aide training and/or Registry testing themselves and then begins work in a LTC within 12 months of completing the course or Registry testing, the employer is required to reimburse or partially reimburse them those costs, prorated on how much of that first year they were employed. Only certified nursing homes or boarding care homes are required to reimburse a nursing assistant.
Can students become a CNA while still in high school?
Yes, there are many high schools that offer a direct path for students to become CNAs before or immediately following high school graduation through partnerships with their local community colleges. These are often referred to as concurrent enrollment partnerships where high school students are earning both high school and college credit for the same course. It is not uncommon for students to also earn industry recognized credentials, such as CNA certification during these same programs and experiences.
What are some other ways to get into health care and nursing?
A growing number of healthcare providers, employers and other partners are embracing work-based learning as a way to grow their workforce. Internships, Quality Pre-apprenticeships and Registered Apprenticeships specifically offer a great way for students to earn a paycheck while learning how to become a CNA. Contact the Iowa Office of Apprenticeship to learn more about apprenticeship opportunities in CNA and other healthcare areas across the state. Funding is sometimes even made available specifically for healthcare programs.