Caregiver roles
What is a CNA?
A CNA is a certified nursing assistant, a nurse aide with formal training. Here is what that training includes, how it differs by state, and what a CNA does in your home.
What is a CNA?
A CNA, or certified nursing assistant, is a nurse aide who completed a state-approved training and competency program. Federal rules set a minimum of 75 hours with at least 16 of supervised practical training. Connecticut requires 100 hours and New Jersey 90. At home, a CNA helps with daily activities such as bathing, dressing and moving safely.
The short answer
What does a CNA do?
A certified nursing assistant gives hands-on help with daily activities: bathing, dressing, toileting, moving from bed to chair, walking, eating, and keeping a person comfortable. A CNA is not a nurse and does not provide nursing care. The CNA works alongside the people who do.
The title comes from a state-approved nurse aide training and competency program. The program was built around nursing homes, which is why federal rules set the training standards for nurse aides in nursing facilities.
How many hours of training does a CNA have?
It depends on the state. The federal rule is the floor, and states can ask for more.
Federal minimum
At least 75 clock hours, including at least 16 hours of supervised practical training. 42 CFR 483.152 also requires 16 hours of training in specified areas before any direct contact with a resident.
Connecticut
Nurse aide training programs must total a minimum of 100 hours, classroom and clinical together, according to the Department of Public Health. The clinical part takes place in a nursing home or rest home.
New Jersey
The Department of Health's training course is 90 hours: 50 classroom and 40 clinical. Ask the Department of Health or the training program about the certification steps that follow.
New York
In a December 2022 notice, the New York State Department of Health extended the federal 75-hour requirement, with 16 hours of supervised practical training before resident contact and 59 hours of classroom instruction, until it is adopted into state regulation. We haven't confirmed whether New York has since adopted a regulation, so check the Department of Health for the current rule.
How is a CNA's work at home different from a nursing home?
In a nursing home, a CNA looks after many residents on a shift, as part of a nursing team. At home, the CNA is usually with one person, in that person's own kitchen, bathroom and routine, and the job includes knowing how your mother likes her tea and where she keeps her glasses.
At Endurance, a CNA works within the care plan a registered nurse writes with the family. That means companion care and personal care, and medication reminders only. It does not include nursing tasks such as managing medicines or caring for wounds. Those come from licensed nurses, and in Connecticut that's Endurance Home Health, a separate company.
In New York, Endurance provides companion care only, so a caregiver there does not provide hands-on personal care.
Why are so many home care caregivers CNAs?
Most Endurance caregivers are CNAs. A CNA arrives with formal training in the physical side of caregiving, such as safe transfers and personal hygiene, and with a competency evaluation behind them. For families, that's one more answer to "how do I know this person can do what you say?"
It's a starting point rather than the whole picture. Endurance also checks backgrounds and references and verifies qualifications before hire, orients caregivers before the first shift, and runs monthly training, including three-hour dementia sessions. Ask any agency the same.
What is the difference between a CNA and a home health aide?
They're separate credentials with overlapping training. A home health aide completes home health aide training and works under a registered nurse's supervision for an agency licensed or certified for it. Federal rules for Medicare-certified agencies count a state-approved nurse aide program, when the person is in good standing on the state registry, toward home health aide training.
States differ. New Jersey's consumer guide says a Department of Health nurse aide certification cannot be substituted for the Board of Nursing's CHHA certification. New York exempts licensed nurses from home health aide training, and a home health aide's New York certification lapses two years after last working at a New York home health agency. So a CNA is not automatically a home health aide, and a home health aide is not automatically a CNA. Ask which credential your caregiver holds.
Questions families ask
What does CNA stand for?
CNA stands for certified nursing assistant. It is a nurse aide who completed a state-approved training and competency evaluation program, with a minimum of 75 hours under federal rules. People also say nurse aide, nursing assistant or nurse's aide for the same credential.
How many hours of training does a CNA need?
Federal rules set a minimum of 75 hours with at least 16 of supervised practical training. Connecticut requires programs of at least 100 hours. New Jersey's course is 90 hours, 50 classroom and 40 clinical. A December 2022 New York Department of Health notice extended the federal 75-hour requirement until it is adopted into state regulation; confirm the current rule with the Department.
Is a CNA a nurse?
No. A CNA is a nurse aide. Registered nurses and licensed practical nurses hold state nursing licenses and carry out a medical regimen, which is nursing practice under state law. A CNA helps with daily activities and works alongside nurses.
Can a CNA give medicine?
At Endurance Home Care, caregivers give reminders only. In Connecticut, the Department of Consumer Protection says registered homemaker-companion agencies may not administer medications or shots or provide nursing services such as assessing blood pressure or wound care. Those come from licensed nurses.
Are Endurance caregivers CNAs?
Most are. Endurance also checks backgrounds and references and verifies qualifications before hire, orients caregivers before the first shift, and offers monthly training, including three-hour dementia sessions. In New York, Endurance provides companion care only, so a New York caregiver does not provide hands-on personal care.
Is a CNA the same as a home health aide?
No. They're separate credentials. Federal rules count a state-approved nurse aide program in good standing toward home health aide training, but New Jersey's guide says the nurse aide certification can't stand in for the CHHA certificate. Ask which credential the caregiver holds and who employs them.
Do I need a CNA, or is a companion enough?
It depends on the help. If your parent needs company, meals and errands, a companion may be enough. If there's hands-on help with bathing, dressing or moving about, ask for a caregiver with formal training, such as a CNA. We help you sort it out on the first call.
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Sources for this page (8)
- 42 CFR 483.152, nurse aide training program requirements
- Connecticut DPH, nurse aide training program requirements
- New Jersey Department of Health, nurse aide certification
- New York State Department of Health, DAL NH 22-21, nurse aide training
- 42 CFR 484.80, home health aide services
- New Jersey Division of Consumer Affairs, home health care consumer guide
- New York State Department of Health, home health aide training FAQ
- Connecticut DCP, A Consumer's Guide to Homemaker-Companion Agencies