Pennsylvania NURSE AIDE

January 2022

verPANA2.0

Pennsylvania

NURSE AIDE

written (or oral) examination

& skills evaluation

Candidate Handbook

QUICK REFERENCE

CREDENTIA REGISTRATION AND SCHEDULING

SERVICES

Pennsylvania NNAAP

(800) 457-6752

Hours of Operation

Mon – Fri 8:00 a.m. – 11:00 p.m.

Sat 8:00 a.m. – 5:00 p.m.

Sun 10:00 a.m. – 4:00 p.m.

(Eastern Time Zone)

Call Customer Service to:

• Check exam scheduling date and/or status

• Find test sites and availability

• Schedule, reschedule or cancel an examination

• Ask questions about online registration

• Obtain information regarding your Score report

• Obtain information regarding your examination

Go to Credentia’s website at

www.credentia.com/test-takers/pa to:

• To view most current exam updates

• Download a Candidate Handbook

• Download a Registration Application

• Download a Reciprocity Application

• View the Nurse Aide Practice Written Examination

• Submit a change of name or address

• Verify your status on the Registry

AFTER THE EXAM DATE

1 (800) 852-0518

Call for questions about:

• Name and address changes AFTER being placed

on the Pennsylvania registry

• The exam content

Hours of Operation

Mon – Fri 8:00 a.m. – 5:00 p.m.

(Eastern Time Zone)

CREDENTIA SERVICES REGISTRY MANAGEMENT

Managed by Credentia

PO Box 13785

Philadelphia, PA 19101-3785

(800) 852-0518

Hours of Operation 8:00 a.m. – 5:00 p.m.

(Eastern Time Zone)

Call to:

• Order Candidate Handbooks

• Clarify information about the Registry

• Change your current address or name once you are

on the Registry

• Obtain instructions to change your name or social

security number once you are on the registry

• Obtain information regarding reciprocity

• Obtain information on continued enrollment on the

Registry

• Obtain a Test Registration Form

PENNSYLVANIA DEPARTMENT OF HEALTH

(DIVISION OF NURSING CARE FACILITIES)

(717) 787-1816

Hours of Operation 8:00 a.m. – 4:30 p.m.

(Eastern Time Zone)

The Pennsylvania Department of Health

administers the Commonwealth contract to

provide nurse aide registry services.

Call the Pennsylvania Department of Health to:

• Inquire about the annotation of nurse aide

registrations

PENNSYLVANIA DEPARTMENT OF EDUCATION

Bureau of Career and Technical Education

333 Market Street

11th Floor

Harrisburg, PA 17126-0333

ra-natcep@pa.gov

Hours of Operation 7:30 a.m. – 4:00 p.m.

(Eastern Time Zone)

The Pennsylvania Department of Education approves

Pennsylvania nurse aide training programs.

Visit the Pennsylvania Department of Education at

www.education.state.pa.us/nurseaide for:

• General information regarding nurse aide training

requirements

• A list of state-approved nurse aide training

programs

PENNSYLVANIA

DEPARTMENT OF HUMAN SERVICES

Office of Long-Term Living

Bureau of Fee For Service Programs

6th Floor, Forum Place Building

555 Walnut Street

Harrisburg, PA 17101

(800) 932-0939, option 1

Hours of Operation 9:00 a.m. – 12:00 p.m.

and 1:00 p.m. – 4:00 p.m.

(Eastern Time Zone)

Call the Department of Human Services to:

• Obtain information/assistance regarding federal

regulations for reimbursement from Nursing

Facilities to employed nurse aides

• Acquire help with any discrepancies in eligibility

for reimbursement

• For issues with testing or test reports,

email: ra-pwnurseaide@pa.gov

DOH and Credentia do not discriminate on the basis of age, sex, race, creed,

disabling condition, religion, national origin, or any other protected characteristics.

NNAAP® Written Exam Content Outline and Practical Skills Listing

TABLE OF CONTENTS

Quick Reference ........................... inside front cover

Introduction ........................................................ 1

National Nurse Aide Assessment Program ............... 1

Exam Overview ........................................................ 1

Eligibility .................................................................. 2

Eligibility by Examination ........................................ 2

Registration and Scheduling ........................... 3

Online Registration and Scheduling ......................... 3

Exam Fees ................................................................. 4

Reimbursement for Training and Testing ................. 5

Exam Scheduling ...................................................... 5

Accommodations ...................................................... 6

Light Duty ................................................................ 6

Cancellation & RESCHEDULING .......................... 7

Refunds .................................................................... 7

Absence Policy .......................................................... 7

Weather Emergencies ................................................ 8

Exam Day (ONLINE EXAM) ...................................... 8

What You'll Need ..................................................... 8

Before Exam Day ...................................................... 8

On Exam Day .......................................................... 9

Exam Day (Test Center EXAM) ........................... 10

Checking In ............................................................. 10

What to Bring ......................................................... 11

Proper Identification ................................................ 11

Security and Cheating ............................................. 11

Testing Policies ........................................................ 12

Lateness ............................................................... 12

Electronic Devices ............................................... 12

Study Aids ........................................................... 12

Eating/Drinking/Smoking ................................... 12

Misconduct .......................................................... 12

Guests/Visitors ..................................................... 12

The Written (or oral) Exam ............................ 13

Written Exam .......................................................... 13

Oral Exam ............................................................... 13

Self-Assessment Reading Test .................................. 13

continued on next page

Written (or Oral) Exam

Content Outline ............................................. 14

Sample Questions ................................................ 15

Self-Assessment reading test ........................... 16

Part 1: Vocabulary ................................................... 16

Part 2: Comprehension ............................................ 18

The Skills Evaluation ......................................... 20

What to Expect ...................................................... 20

Setting ................................................................ 20

Who Will Act as a Client? .................................. 20

Candidate Volunteer Requirements ..................... 21

The Tasks ................................................................ 21

Recording a Measurement ...................................... 22

Sample Recording Sheet

for Measurement Skills ....................................... 23

Tips for the Skills Evaluation ............................. . 24

Skills Listing .................................................... 25-40

Score Reporting .................................................. 41

Exam Results ........................................................... 41

Score Reporting ................................................... 41

Failing ...................................................................... 41

How to Read a Failing Score Report ...................... 42

Passing .................................................................... 43

grievance process ............................................... 44

The Registry ........................................................... 44

Registry Renewal .................................................... 44

CNA365 .................................................................. 45

Change of Address or Name .................................... 45

Lost Registry Cards ................................................ 46

Re-activating Inactive Status .................................. 46

Reciprocity ............................................................... 47

PA nurse aide Registry —

frequently asked questions .................. 48-55

DUPlicate Regristry CarD Request...............56-57

INTRODUCTION

is handbook is designed for candidates seeking enroll-

ment on the Pennsylvania Nurse Aide Registry. It describes

the process of applying for the National Nurse Aide

Assessment Program (NNAAP®) and taking the NNAAP®

Examination. It should be kept for future reference.

e Pennsylvania Department of Health has contracted

with Credentia, a nationally recognized leading provider

of assessment services to regulatory agencies and national

associations, to develop, score, and report the results of the

competency examination for the Pennsylvania Nurse Aide

Registry. Credentia also processes applications, schedules

examinations, and administers the examinations.

NATIONAL NURSE AIDE ASSESSMENT

PROGRAM (NNAAP®)

e Nursing Home Reform Act, adopted by Congress as

part of the Omnibus Budget Reconciliation Act of 1987

(OBRA ’87), was designed to improve the quality of care

in long-term health care facilities and to dene training

and evaluation standards for nurse aides who work in such

facilities. Each state is responsible for following the terms

of this federal law.

e National Nurse Aide Assessment Program (NNAAP®)

is an examination program designed to determine minimal

competency to become a licensed nurse aide in your state.

e NNAAP was developed by the National Council of

State Boards of Nursing, Inc., (NCSBN) to meet the nurse

aide evaluation requirement of federal and state laws and

regulations. Credentia is the authorized administrator of the

NNAAP in your state.

e NNAAP Examination is an evaluation of nurse

aide-related knowledge, skills, and abilities. e NNAAP

Examination is made up of both a Written (or Oral)

Examination and a Skills Evaluation. e purpose of the

NNAAP Examination is to test that you understand and

can safely perform the job of an entry-level nurse aide.

EXAM OVERVIEW

e two parts of the NNAAP Examination include, the

Written (or Oral) Examination and the Skills Evaluation,

You must pass both parts in order to be listed on the

Pennsylvania Nurse Aide Registry.

You may take Written (or Oral) examinations either online

or at a test center. Skills Evaluations are only oered at a

test center.

e Written Examination consists of seventy (70) multi-

ple-choice questions written in English. Sample exami-

nation questions are provided in this handbook. An

Oral Examination may be taken in place of the Written

Examination if you have diculty reading English. e

Oral Examination consists of sixty (60) multiple-choice

questions plus ten (10) reading comprehension/word

recognition questions. If you want to take the Oral

Examination, you must request it when you submit your

registration form.

For the Skills Evaluation you will be asked to perform ve

(5) randomly selected nurse aide skills. You will be rated

on these skills by a Nurse Evaluator. A complete listing of

the skills is shown on pages 24 to 39.

See The Written (or Oral) Exam and The Skills Evaluation

for more details about the NNAAP Examination.

ELIGIBILITY

ELIGIBILITY BY EXAMINATION

Please note that in order to be eligible for employment as a

nurse aide in Pennsylvania, you MUST be sixteen (16) years

of age or older. You MUST also submit to a criminal back-

ground check and you MUST NOT have any exclusionary

convictions on record or have substantiated findings on any

other state registry or licensing board.

You are eligible for testing if:

E-0

You have completed a nurse aide training program,

approved by the Pennsylvania Department of Education,

within the last twenty-four (24) months.

E-3

Your Pennsylvania nurse aide registration has lapsed

because you have not worked providing nursing-relat-

ed services for at least 24 consecutive months. An E-3

candidate has one (1) opportunity to successfully pass the

NNAAP Examination. If the examination is failed, the

candidate must complete nurse aide training again and

reapply under eligibility route E-0.

E-4

You are a licensed nurse aide on another state's nurse

aide registry, but your licensure has lapsed because

you have not worked providing nursing-related servic-

es for at least 24 consecutive months. An E-4 candidate

has one (1) opportunity to successfully pass the NNAAP

Examination. If the examination is failed, the candidate

must complete nurse aide training again and reapply

under eligibility route E-0.

Note: Consistent with 42 CFR 483.75(e)(2), nursing

home administrations may employ a non-registered indi-

vidual as a nurse aide for up to 120 days while the indi-

vidual works to achieve registration in PA either through

the nurse aide training and testing program, or by way of

reciprocity from another state.

E-6A

You are a temporary nurse aide and have completed a

Nurse Aide Attestation Form and intend to sit for the

PA nurse aide examination. The TNA candidate has 3

attempts to pass the competency exam.

REGISTRATION

AND SCHEDULING

ONLINE REGISTRATION AND

SCHEDULING

With the Credentia CNA365 system, online registration

is quick, convenient and an environmentally responsible

way to register for your examination. is process will

eliminate the transit time associated with mailing a paper

application. A detailed step-by-step reference guide on

how to create a CNA365 account and register for exams

can be found at www.credentia.com/test-takers/pa.

After completing a Pennsylvania state-approved training

course, you will create an online account with Credentia’s

CNA365 system. To create a CNA365 account, click the

“CNA365 Login” button on the top of the Pennsylvania

nurse aide website page at www.credentia.com/test-takers/

pa.

• Payment is in the form of a credit card or pre-paid

credit card (American Express, MasterCard, Visa,

ACH/ electronic check, or electronic voucher). Fees

are non-refundable and non-transferable once sub-

mitted.

• For exams at test center locatons, you must make

an online reservation via a PC (smart phones and

tablets are not recommended) at least ten (10) cal-

endar days prior to the test date.

• For Written (or Oral) online exams, you may sched-

ule an exam as early as the following day depending

on exam availability.

• You are responsible for completing an online appli-

cation in CNA365. You may ask someone from

your nurse aide training program or facility employ-

er for assistance in completing the application. If

you need help or have any questions about the

application process, contact a support representative

at 800-457-6752.

EXAM FEES

e fees listed below have been established for the National

Nurse Aide Assessment Program in Pennsylvania:

Written

Examination &

Skills Evaluation

both exams $135

Oral Examination

& Skills

Evaluation

both exams $135

Written

Examination

ONLY

re-test exam $50

Skills Evaluation

ONLY

re-test exam $85

Oral Examination

ONLY

re-test exam $50

You must pay for both the Skills Evaluation and the

Written (or Oral) Examination the first time you test.

Under federal and Pennsylvania laws, nursing homes are

required to pay the NNAAP fees for their nurse aide

employees, including individuals required to re-test.

Payment must be made in the form of a credit card,

debit card, ACH (electronic check), or electronic vouch-

er. Vouchers can be purchased by the training programs

or sponsors.

Fees are not refundable.

REIMBURSEMENT FOR TRAINING

AND TESTING

Federal law prohibits these charges from being

imposed on the nurse aide. Nursing Care Facilities

(Medicare and Medicaid) are responsible for the full

payment of training and testing costs for individuals

employed or oered employment at the time the indi-

vidual enters a Nurse Aide Training and Competency

Evaluation Program (CEP). An individual who does

not have an employment relationship with a facility at

the time the individual enters a NATCEP or CEP, but

becomes employed, or obtains an oer of employment

within 12 months of completing the program, will be

reimbursed for the costs of training and testing by the

facility that employs or oers employment to this individ-

ual. is reimbursement will be made on a pro rata basis

for the period during which the individual is employed as

a nurse aide. e nurse aide will be reimbursed for half

the costs of training and testing after the nurse aide has

worked at the facility as a nurse aide for 130 hours and

the remaining half of the training and testing costs after

the nurse aide has worked an additional 130 hours. e

hours start accruing when the individual has successfully

tested and is listed on the registry. is veries that the

individual has completed the program and qualies for

the training and testing reimbursement.

EXAM SCHEDULING

Once your online application has been approved, you

will be able to schedule for exams in CNA365. A detailed

step-by-step reference guide on how to schedule exams

can be found at www.credentia.com/test-takers/pa. When

completed, you will receive a Conrmation Notice and

Receipt of Payment via email.

ACCOMMODATIONS

Credentia complies with the provisions of the Americans

with Disabilities Act as amended. e purpose of accom-

modations is to provide candidates with full access to the

test. Accommodations are not a guarantee of improved

performance or test completion. Credentia provides rea-

sonable and appropriate accommodations to individuals

with documented disabilities who demonstrate a need for

accommodations.

Test accommodations may include things such as:

• A separate testing room

• Extra testing time

• A Reader or Recorder, for individuals with mobility,

hearing, or vision impairments and cannot read or

write on their own

Test accommodations are individualized and considered

on a case-by-case basis. All candidates who are request-

ing accommodations because of a disability must provide

appropriate documentation of their condition and how

it is expected to aect their ability to take the test under

standard conditions. is may include:

• Supporting documentation from the professional

who diagnosed the condition, including the cre-

dentials that qualify the professional to make this

diagnosis

• A description of past accommodations the candi-

date has received

Please visit www.credentia.com/accommodations full

details on the accommodations process and required sup-

porting documentation.

LIGHT DUTY

Federal law prohibits any individual from taking the Skills

Evaluation if he/she is on restricted activity or light duty

due to medical reasons. Candidates must be able to com-

plete all required skills included in the Skills Evaluation.

THERE ARE NO EXCEPTIONS TO THIS RULE.

Candidates who are on light duty are not permitted to

take the Skills Evaluation; however, light duty does not

prevent a candidate from taking the Written Examination.

Appropriate medical documentation stating a return to

full, unrestricted duty is required to reschedule the skills

exam.

CANCELLATION AND

RESCHEDULING

You may cancel or reschedule an examination online in

your CNA365 account. For details on how to cancel or

reschedule an examination, visit www.credentia.com/test-

takers/pa and click on “How to Cancel or Reschedule an

Exam” in the Resources section of the webpage.

Online Written (or Oral) examinations must be can-

celed or rescheduled at least 48 hours before the scheduled

examination time.

Test center examinations must be canceled or resched-

uled at least nine (9) business days before the scheduled

examination date (Saturday and Sunday and national

holidays are not considered business days).

If you do not cancel or reschedule your examination with-

in the required timeframes detailed and do not show up

for your scheduled examination, you will be responsible

for the examination fee. Your fee will not be refunded and

cannot be transferred to a new examination date, and you

may not give your examination date to another person.

If you do not report to an examination at your scheduled

time, you will be considered a “no-show” and fees paid

will be forfeited. An un-excused absence will also count as

one of your 3 “opportunities” to pass the exam.

REFUNDS

Once payment of exam fees is received, NO REFUNDS

WILL BE ISSUED.

ABSENCE POLICY

Candidates who are late or absent from an exam may call

Credentia within 14 days of the exam date to request an

excused absence for the following reasons:

• Illness of yourself or a member of your immediate

family

• Death in the family

• Disabling traffic accident

• Court appearance or jury duty

• Military duty

WEATHER EMERGENCIES

A test center examination will be delayed or cancelled

only in emergencies. If severe weather or a natural disaster

makes the test site inaccessible or unsafe, the examination

will be delayed or cancelled. In the event of an examana-

tion change due to a weather emergency, candidates will

be contacted by phone and email with change details.

EXAM DAY (ONLINE EXAM)

Take your written/oral exam conveniently from home or

work through Credentia online proctoring. A live proctor will

monitor you through the webcam on your workstation to

provide a secure exam experience. Online exams also oer sig-

nicantly more scheduling exibility than test center exams to

best meet your availability.

Please visit www.credentia.com/online-exams for information

on what to expect and how to best prepare for your online

exam. We also recommend that you click on the “Policies &

Procedures” link on this webpage to review detailed exam

rules and procedures.

WHAT YOU'LL NEED

• A properly equipped computer - a desktop, laptop, or

Chromebook with a single monitor (no smartphones or

tablets). Visit www.credentia.com/online-exams to view

or download system requirements.

• A private room - if you don't have access to a private

room, check with your training program or local library

for availability.

• A mobile device - to complete a 360 degree room scan,

you'll need a smartphone or tablet (Apple or Android)

that can download our free app.

BEFORE EXAM DAY

• Perform a system test – make sure to do the required

system test and exam simulation before exam day.

Visit www.credentia.com/online-exams and select the

“Run System Test” button.

• Find your testing space – Find a quiet, distraction-

free area in your home or oce to take your exam.

• Get your ID ready - You are required to bring two (2)

forms of ocial, signature-bearing identication (one

of which must be a photo identication). Photocopies

of identication will NOT be accepted. Examples of

proper identication include:

• Driver’s license

• Social Security card

• Clinic card

• Credit card

• Library card

• State-issued identication card

• Passport

• Alien registration card

e name on your identication must be the same as the

name you used on the application to register for the exam-

ination. If you do not bring proper identication, you will

not be allowed to test and your examination fee will not

be refunded. is absence will count as one of your 3

opportunities to test because you were not prepared with

the correct forms of identication.

ON EXAM DAY

STEP 1: Prepare your testing space

• Quiet: no background noise and inform mem

bers of your household you are taking an exam

• Well lit: proctors must be able to see you and

your testing space well.

• Privacy: no one else in the room.

• Remove prohibited items: clear workstation

area to expedite room scan

• Restroom/Beverages: use restroom and prepare

beverages before exam.

STEP 2: Have your ID ready

• Have your government issued photo ID with you

(see list or proper identication in section above).

STEP 3: Prepare your computer

• Disconnect any additional monitors and close

all other open applications.

• Have your chargers (laptop, smart phone or

tablet) plugged in or nearby

• Use a wired internet connection rather than

WiFi, if possible.

• If using WiFi, we recommend at least 3Mbps

and ask that other household members do not

use the internet during your exam.

• Disconnect any VPNs or rewalls if you have

them.

STEP 4: Download the ExamRoom 360 app

• Download the ExamRoom 360 app to your

smartphone or tablet and have your CNA365

password for your Credentia CNA365 account).

is app is required to complete a 360 degree

room scan.

STEP 5: Check-in for your exam

• When to check-in - you can begin the check

in process up to 30 minutes prior to your

appointment. Your onboarding agent will make

sure everything is ready for your exam

before introducing your proctor. Visit www.

credentia.com/online-exams to view or

download detailed check-in procedures.

• How to check-in - go to www.credentia.com/

test-takers/pa and click the “CNA365 login”

button. Once logged in, nd your sched

uled exam and select the "Start Exam" button.

EXAM DAY (TEST CENTER EXAM)

Please visit www.credentia.com/test-center-exams for infor-

mation on what to expect and how to best prepare for your

test center exam.

CHECKING IN

You must arrive 30 minutes prior to your scheduled time for

BOTH the written examination and for the skills evaluation.

If you are late for the written examination, you will not be

allowed to test and your fees will not be refunded. If you

missed your written examination and are scheduled for a skills

evaluation, please arrive 30 minutes prior to your scheduled

time. Skills Evaluation test times are approximate.

You will be required to check in for both the written

examination and for the skills evaluation. You will be

required to present proper identication.

WHAT TO BRING

You MUST have the following items with you when you

take the NNAAP Examination:

• Two (2) forms of ocial (current, not expired),

legible, signature-bearing identication, one of

which must be photo identification

• Three (3) No. 2 pencils (sharpened)

• Eraser

• Watch with a second hand

No other materials will be allowed.

PROPER IDENTIFICATION

You are required to bring two (2) forms of ocial, signa-

ture-bearing identication to the test site (one of which

must be a photo identication). Photocopies of identica-

tion will NOT be accepted. Examples of proper identica-

tion include:

• Driver’s license

• Social Security card

• Clinic card

• Credit card

• Library card

• State-issued identification card

• Passport

• Alien registration card

e name on your identication must be the same as

the name you used on the application to register for the

examination.

If you do not bring proper identification, you will not

be allowed to test and your examination fee will not

be refunded. This absence will count as one of your

3 opportunities to test because you were not prepared

with the correct forms of identification.

SECURITY AND CHEATING

If you give help to or receive help from anyone during

the NNAAP Examination, the examination will be

stopped. e incident will be reported to the Pennsylvania

Department of Health for review, and your examination

will not be scored (see Testing Policies).

Please note that all examination questions, each form of

the examination, and all other examination materials are

copyrighted by, the property of, or licensed to Credentia.

Consequently, any distribution of the examination content

or materials through any form of reproduction, or through

oral or written communication, is strictly prohibited and

punishable by law.

Anyone who removes or tries to remove examination

material or information from the test site will be pros-

ecuted.

TESTING POLICIES

e following policies are observed at each test site.

Lateness

Plan to arrive thirty (30) minutes before the examination

starts. If you are late for your scheduled examination, or

do not bring all your required materials, you will NOT

be allowed to test and your examination fee will NOT be

returned.

Electronic Devices

Cellular phones, beepers, or any other electronic devices

are not permitted to be used and must be turned o dur-

ing testing, and there is no place for storage of personal

belongings at the test sites.

Study Aids

You are not permitted to take personal belongings such as

briefcases, large bags, study materials, extra books, or papers

into the examination room. Any such materials brought into

the examination room will be collected and returned to you

when you have completed the examination. Credentia is not

responsible for lost or misplaced items.

Eating/Drinking/Smoking

You are not permitted to eat, drink, or smoke during the

examination.

Misconduct

If you are discovered causing a disturbance of any kind or

engaging in any kind of misconduct, you will be dismissed

from the examination and reported to the Department of

Health. Decisions regarding disciplinary measures are the

responsibility of that agency.

GUESTS/VISITORS

No guests, visitors, pets, or children are allowed at the

test sites

THE WRITTEN

(OR ORAL) EXAM

WRITTEN EXAM

e Written Examination has seventy (70) multiple-

choice questions. You will have two (2) hours to complete

the Written Examination. You will be told when fteen

(15) minutes are left to nish. Fill in only one (1) oval

on the answer sheet or computer screen (online exam)

for each question. For test center exams, markings in the

test booklet will not be accepted as answers. Your answers

must appear on the separate answer sheet. Sample ques-

tions for the Written Examination are located on page 14.

ORAL EXAM

e Oral Examination consists of sixty (60) multiple-

choice questions and ten (10) reading comprehension

questions and is given on an MP3 player for test center

exams. For online exams, questions will be read by

recorded voice. Each of the sixty (60) multiple-choice

questions will be repeated two (2) times, after which

you mark your answer on an answer sheet. e reading

comprehension questions test your knowledge of and

familiarity with common, job-related words. Each of these

words is repeated three (3) times. You have two (2) hours

to complete the entire Oral Examination. You must pass

both the multiple-choice and reading comprehension sec-

tions in order to pass the Oral Examination.

SELF-ASSESSMENT

READING TEST

A self-assessment reading test, found on page 15 of this

handbook, will help you decide if you should take the

Oral Examination.

2016 WRITTEN (OR ORAL)

EXAM CONTENT OUTLINE

e revised content outline is based on the ndings from

the 2014 Job Analysis and Knowledge, Skill, and Ability

Study of Nurse Aides published by the National Council of

State Boards of Nursing (NCSBN) in 2015. e examina-

tion content outline will be eective January 2016.

e NNAAP written examination is comprised of 70

multiple-choice items; 10 of these items are pretest (non-

scored) items on which statistical information will be

collected. e NNAAP oral examination is comprised of

60 multiple-choice items and 10 reading comprehension

(word recognition) items. e candidate is allowed to

choose between a written and an oral examination.

# of

% of questions

I. Physical Care Skills the exam in the exam

A. Activities of Daily Living ........ 14% ............9

1. Hygiene

2. Dressing and Grooming

3. Nutrition and Hydration

4. Elimination

5. Rest/Sleep/Comfort

B. Basic Nursing Skills .................39% ............ 23

1. Infection Control

2. Safety/Emergency

3. Therapeutic/Technical Procedures

4. Data Collection and Reporting

C. Restorative Skills ...................... 8% .............5

1. Prevention

2. Self Care/Independence

II. Psychosocial Care Skills

A. Emotional and

Mental Health Needs ..............11% .............6

B. Spiritual and Cultural Needs ....2% ..............2

III. Role of the Nurse Aide

A. Communication ....................... 8% .............4

B. Client Rights ........................... 7% .............4

C. Legal and Ethical Behavior ...... 3% .............2

D. Member of the

Health Care Team ................... 8% .............5

SAMPLE QUESTIONS

e following questions are samples of the kinds of ques-

tions that you will nd on the Written Examination.

Check your answers to these questions in the box below.

1. The client’s call light should always be placed:

(A) on the bed

(B) within the client's reach

(D) over the side rail

2. Which of the following items is used in the pre-

vention and treatment of bedsores or pressure

sores?

(A) rubber sheet

(B) air mattress

(D) restraint

3. When caring for a dying client, the nurse aide

should:

(A) keep the client’s room dark and quiet

(B) allow client to express his feelings

(D) contact the client’s minister, priest or rabbi

4. What does the abbreviation ADL mean?

(A) Ad Lib

(B) As Doctor Likes

(D) After Daylight

5. After giving a client a back rub, the nurse aide

should always note:

(A) the last time the client had a back rub

(B) any change in the client's skin

(D) amount of lotion used

6. How should the nurse aide communicate with a

client who has a hearing loss?

(A) face the client when speaking

(B) repeat the statement

(D) use a high-pitched voice

Correct Answers

1. B 2. B 3. B 4. C 5. B 6. A

SELF-ASSESSMENT

READING TEST

e two (2)-part Self-Assessment Reading Test that appears

below will help you decide if you should consider taking the

Oral Examination instead of the Written Examination. To

complete the reading test, follow the instructions provided

below and select the answer to each question. When you

have completed the reading test, you will be able to deter-

mine the number of questions you answered correctly.

PART 1: VOCABULARY

1. Circle the best answer to each question.

2. When you have finished, check your answers using

the answer key on page 18.

3. Count up the number of correct answers.

4. If your score is less than 17, you may have difficulty

reading the Written Examination and should con-

sider taking the Oral Examination.

1. You go to a doctor when you _____.

(A) feel sleepy (D) need money

(B) need socks (E) need clothes

2. A person who flies an airplane is its _____.

(A) pilot (D) surgeon

(B) steward (E) director

3. You use a _____ to write.

(A) bow (D) carpenter

(B) calculator (E) needle

4. To EXIT a room means to _____ it.

(A) enter (D) read

(B) leave (E) interrupt

5. A wedding is a joyous _____.

(A) focus (D) occasion

(B) vehicle (E) civilization

6. To REQUIRE something means to _____ it.

(A) need (D) understand

(B) have (E) hear

go to next page

7. You _____ something to find its length.

(A) slice

(B) lock

(D) force

(E) tape

8. Soup is served in a _____.

(A) plate

(B) bowl

(D) chair

(E) closet

9. To accompany someone means to _____.

(A) disagree with him

(B) work for him

(D) speak to him

(E) choose him

10. A nursing home resident receives _____ from the

staff.

(A) quality

(B) fame

(D) care

(E) work

11. Medicine is used to _____ pain.

(A) widen

(B) conjure

(D) increase

(E) relieve

12. To DRENCH the flowers means to ____ them.

(A) steam

(B) drink

(D) soak

(E) anger

13. A bicycle is a means of _____.

(A) nourishment

(B) transportation

(D) collision

(E) walking

14. When somone speaks in a whisper it may be

difficult to _____.

(A) deceive

(B) understand

(D) estimate

(E) regulate go to next page

SELF-ASSESSMENT

READING TEST

PART 2: COMPREHENSION

In this part of the reading test you will be provided with a

series of brief paragraphs. You are to read each paragraph and

then answer the questions that appear after the paragraph.

There are many different kinds of fish. All fish live

in water. They use their tails and fins to swim.

15. Fish live in _____.

(A) cups

(B) houses

(D) water

(E) fountains

16. Fish use their _____ to swim.

(A) tails

(B) heads

(D) lungs

(E) floats

Maria grew up on a farm. She loved the work on

the farm. She knew when all of the crops had to

be planted. She would like a job on a farm or in a

flower garden.

17. Maria has had experience as a _____.

(A) guide

(B) farmer

(D) nurse

(E) teacher

18. She would like to work in _____.

(A) an office

(B) a library

(D) a hospital

(E) a supermarket

19. As a child Maria lived _____.

(A) in the city

(B) in an apartment

(D) in a large house

(E) on the beach go to next page

Carolyn has a good job. She is a nurse in a large hos-

pital. Every day she can help many people. She enjoys

this very much. She also makes a good salary. Each

month she can pay her bills and save some money.

20. Carolyn works in a _____.

(A) hospital

(B) doctor’s office

(D) school

(E) library

21. One of the things Carolyn enjoys is _____.

(A) working in an office

(B) helping people

(D) working late hours

(E) driving a car

22. With her salary she can pay her bills and _____.

(A) buy furniture

(B) give to charity

(D) buy new clothes

(E) pay for college

This completes the

Self-Assessment Reading Test.

Answers

1. C 7. C 13. B 19. C

2. A 8. B 14. B 20. A

3. C 9. C 15. D 21. B

4. B 10. D 16. A 22. C

5. D 11. E 17. B

6. A 12. D 18. C

If your score is less than 17, you may have difficulty

reading the Written Examination and should consider

taking the Oral Examination in place of the Written

Examination.

THE SKILLS EVALUATION

WHAT TO EXPECT

e Skills Evaluation is set up to resemble an actual care-

giving situation. e Skills Evaluation area will look similar

to your work setting. It will have all the equipment neces-

sary to perform the assigned skills. e Skills Evaluation

will be administered by a Nurse Aide Evaluator. Before

your skills evaluation begins, the evaluator will show you

where equipment is located and answer questions about

operating the equipment. Please arrive 30 minutes early.

Test times are approximate. Please plan to spend the

day. See pages 24-39 for the complete skills listing.

Who Will Act as a Client?

e part of the “client” will be played by a candidate who

volunteers to act as a weakened elderly person. While you per-

form the skills, speak to the candidate volunteer as you would

speak to an actual client in a nurse aide work setting. You

are encouraged to speak to the candidate volunteer not only

because it is part of quality care, but also because it will help

you to relax as you perform the skills. Please note, you may

not receive help from anyone during the Skills Evaluation,

and the candidate and the client must speak to one another

in English so that the evaluator can understand and correctly

score the evaluation. If either candidate gives help or receives

help during the test, or the client and candidate are communicat-

ing in a language other than English, the test will be stopped.

Candidate Volunteer

Requirements

You will need to act as a candidate volunteer for another nurse

aide’s Skills Evaluation and play the role of a nursing home

patient (client). e evaluator will give you verbal instructions

that will describe how you should act in performing the role

of the client.

You must wear at, slip-on, non-skid shoes; a loose-tting

top with short sleeves that can be rolled up to the shoulder,

or tank top; and loose tting pants that can be rolled up. You

will be required to put a gown on over your clothing. In no

case may candidates remove clothing down to undergarments.

Prior to beginning the exam, you should inform the evalu-

ator of any food or latex allergy or sensitivity to skin soaps

or lotion. Any limitations to range of motion must also be

communicated to the evaluator prior to the start of the skills

examination.

For infection control purposes, you should not come to the

test site with open areas/sores on the skin. Candidates with

any open areas or sores on their skin should reschedule their

skills test to a later date after their skin fully heals.

THE TASKS

e NNAAP Skills List contains all of the skills that you

may be asked to demonstrate during the Skills Evaluation.

Each skill represents a task that you will be asked to per-

form in your job and has been broken down into a series

of steps.

A step that is highlighted in bold type is called a Critical

Element Step. Critical Element Steps are important steps

that must be performed correctly in order for you to pass

the skill. If you leave out a Critical Element Step or do

not perform a Critical Element Step properly, you will not

pass the skill. However, if you perform only the Critical

Element Step correctly in a skill, you do not automati-

cally pass that skill. You must also correctly demonstrate

enough steps to meet the passing standard (or cut score)

for each skill.

Before your Skills Evaluation begins, the Nurse Aide

Evaluator will give you an instruction card that will list the

ve (5) skills selected for you to perform. Hand-washing will

always be one of the skills to be performed. e remaining

four (4) skills are randomly chosen from the complete set of

skills listings on pages 24 to 39 of this handbook. You are

strongly encouraged to perform the skills in the order they

are listed on the instruction card.

If you make a mistake, say so, and you will be instructed

to tell the evaluator which step(s) is to be corrected and

then to perform the step(s). You will not have to redo the

entire skill, just the steps you wish to correct. ere are,

however, some exceptions to this rule. If you fail to put

on gloves or take them o when it is required to do so and

the evaluator reminds you to do so, for infection control

purposes, then you will not receive credit for attempting to

correct this step. If you wish to correct an order-dependent

step (a step stating that an action should be performed

before or after another step) and you fail to say when the

corrected step should be performed, you will not receive

credit for the correction.

Once you begin a new skill, you may not go back to

correct a previous skill. e Nurse Aide Evaluator will

not answer questions during the Skills Evaluation and

will not tell you whether you performed a skill correctly.

You may not receive help from anyone during the Skills

Evaluation. If you do have any questions, please ask them

before the Skills Evaluation begins.

One (1) of the four (4) randomly-selected skills will include

a measurement skill (see the section below, Recording A

Measurement, for more information regarding measure-

ment skills).

You must successfully complete five (5) out of the five (5) skills

in the skill form to pass the Skills Evaluation. You will have

30 minutes to demonstrate all 5 skills. When 25 min-

utes have elapsed the nurse aide evaluator will advise

you that you have 5 minutes left.

When you have completed your skills evaluation, the

evaluator will direct you to wash your hands. Although

this will not eect your examination results, for the pur-

poses of infection control, you must wash your hands.

RECORDING A MEASUREMENT

e NNAAP Skills Evaluation requires every candidate

to perform one measurement skill, such as blood pressure,

radial pulse, respirations, urine output, or weight. You

will be given a special form, called a Recording Sheet for

Measurement Skills, to write down, or record, the measure-

ment. For example, if performing the Measures and Records

Blood Pressure skill, you will write the complete systolic and

diastolic pressures of your blood pressure reading in a box

labeled Candidate Results.

On the following page is a copy of the recording sheet that

will be used during the skills exam. e candidate must

record his/her results in the Candidate Results box on this

sheet. is sheet will be used to record the results of the

following measurement skills:

• Measures and Records Blood Pressure

• Measures and Records Weight of

Ambulatory Client

• Measures and Records Urinary Output

• Counts and Records Radial Pulse

• Counts and Records Respirations

Tips for the Skills Evaluation

• You will be expected to perform the skills as you would

in a nursing home setting. When water is required, you

must use running water. All candidates will be required

to perform the Hand Hygiene skill. The evaluator will

inform you after you have washed your hands for the

first time that you should just tell him or her when you

would wash your hands during your performance of

the rest of the skills, rather than actually washing them

for each skill. For all steps other than hand-washing,

you must actually perform the skill in order to receive

credit. You may not simply tell the evaluator what you

would do for simulating a step. For example, you may

not simply tell the evaluator that you would wash the

client. You must actually demonstrate washing the

client. You may not simply tell the evaluator that you

would feed the client. You must actually demonstrate

feeding the client.

• After you have introduced yourself to the client for

the first time, it is not necessary for you to introduce

yourself each time you begin a new skill.

• To receive full credit for a measurement skill, you

must accurately make the required measurement and

then write that measurement on the Recording Sheet

for Measurement Skills. The evaluator will provide the

Recording Sheet to you at the test site. A sample of the

Recording Sheet is shown on page 24 of this hand-

book. You are encouraged to become familiar with the

Recording Sheet before your scheduled test date.

• You must know how to operate both a standing and

a non-digital bathroom scale and must know how to

set both types of scales to zero.

• You may not bring any of your own equipment to

the test site (i.e. transfer/gait belt).

• It is important for you to place the call signal within

the client’s reach whenever you leave the client.

• Where the word “client” appears, it refers to the person

receiving care.

2524

Date

Test Site ID

CANDIDATE NAME

CANDIDATE ID

EVALUATOR NAME

EVALUATOR ID

SKILL TESTED

Evaluator must check one box

next to the skill being tested.

■

Blood Pressure

■

Respirations

■

Oral Temperature

■

Urine Output

■

Radial Pulse

■

Weight

RECORDING SHEET FOR

MEASUREMENT SKILLS

CANDIDATE EVALUATOR

RESULTS RESULTS

SAMPLE

CCrreeddeennttiiaa

Tips for the Skills Evaluation

• You will be expected to perform the skills as you

would in a nursing home setting. When water is

required, you must use running water. All candidates

will be required to perform the Hand Hygiene skill.

The evaluator will inform you after you have washed

your hands for the first time that you should just tell

him or her when you would wash your hands during

your performance of the rest of the skills, rather than

actually washing them for each skill. For all steps

other than hand-washing, you must actually perform

the skill in order to receive credit. You may not simply

tell the evaluator what you would do for simulating a

step. For example, you may not simply tell the evalua-

tor that you would wash the client. You must actually

demonstrate washing the client. You may not simply

tell the evaluator that you would feed the client. You

must actually demonstrate feeding the client.

• After you have introduced yourself to the client for

the first time, it is not necessary for you to introduce

yourself each time you begin a new skill.

• To receive full credit for a measurement skill, you

must accurately make the required measurement and

then write that measurement on the Recording Sheet

for Measurement Skills. The evaluator will provide the

Recording Sheet to you at the test site. A sample of the

Recording Sheet is shown on page 22 of this hand-

book. You are encouraged to become familiar with the

Recording Sheet before your scheduled test date.

• You must know how to operate both a standing and

a non-digital bathroom scale and must know how to

set both types of scales to zero.

• You may not bring any of your own equipment to

the test site (i.e. transfer/gait belt).

• It is important for you to place the call signal within

the client’s reach whenever you leave the client.

• Where the word “client” appears, it refers to the person

receiving care.

SKILLS LISTING

e 23 skills that follow are arranged in alphabetical

order, except for the Hand Hygiene (Hand Washing) skill.

Hand Hygiene is listed rst as a reminder of the impor-

tance of performing this skill before all other skills. e

numbered lines below each skill are the steps needed to

perform that skill. Critical Element Steps are in bold type.

SKILL 1 — HAND HYGIENE (HAND WASHING)

1 Address client by name and introduces self to client by

name

2 Turns on water at sink

3 Wets hands and wrists thoroughly

4 Applies soap to hands

5 Lathers all surfaces of wrists, hands, and ngers

producing friction, for at least 20 (twenty) seconds,

keeping hands lower than the elbows and the

ngertips down

6 Cleans ngernails by rubbing ngertips against palms

of the opposite hand

7 Rinse all surfaces of wrists, hands, and ngers, keeping

hands lower than the elbows and the ngertips down

8 Uses clean, dry paper towel/towels to dry all surfaces

of ngers, hands, and wrists starting at ngertips then

disposes of paper towel/towels into waste container

9 Uses clean, dry paper towel/towels to turn o faucet

then disposes of paper towel/towels into waste

container or uses knee/foot control to turn o faucet

10 Does not touch inside of sink at any time

SKILL 2 — APPLIES ONE KNEE-HIGH ELASTIC

STOCKING (Tested on the candidate volunteer with a

clean, unused stocking)

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Client is in supine position (lying down in bed) while

stocking is applied

4 Turns stocking inside-out, at least to the heel

5 Places foot of stocking over toes, foot, and heel

Skill continues

6 Pulls top of stocking over foot, heel, and leg

7 Moves foot and leg gently and naturally, avoiding force

and over-extension of limb and joints

8 Finishes procedure with no twists or wrinkles and

heel of stocking, if present, is over heel and opening

in toe area (if present) is either over or under toe

area; if using a mannequin, candidate may state

stocking needs to be wrinkle-free

9 Signaling device is within reach and bed is in low

position

10 After completing skill, wash hands

SKILL 3 — ASSISTS TO AMBULATE USING

TRANSFER BELT

1 Explains procedure, speaking clearly, slowly, and directly,

maintaining face-to-face contact whenever possible

2 Privacy is provided with a curtain, screen, or door

3 Before assisting to stand, client is wearing non-skid

shoes/footwear

4 Before assisting to stand, bed is at a safe level

5 Before assisting to stand, checks and/or locks bed wheels

6 Before assisting to stand, client is assisted to sitting

position with feet at on the oor

7 Before assisting to stand, applies transfer belt securely

at the waist over clothing/gown

8 Before assisting to stand, provides instructions to

enable client to assist in standing including prearranged

signal to alert client to begin standing

9 Stands facing client positioning self to ensure safety of

candidate and client during transfer. Counts to three

(or says other prearranged signal) to alert client to

begin standing

10 On signal, gradually assists client to stand by grasping

transfer belt on both sides with an upward grasp

(candidate’s hands are in upward position), and

maintaining stability of client’s legs by standing knee to

knee, or toe to toe with client

11 Walks slightly behind and to one side of client for a

distance of ten (10) feet, while holding onto the belt

12 Assists client to bed and removes transfer belt

13 Signaling device is within reach and bed is in low

position

14 After completing skill, wash hands

SKILL 4 — ASSISTS WITH USE OF BEDPAN

1 Explains procedure speaking clearly, slowly, and directly,

maintaining face-to-face contact whenever possible

2 Privacy is provided with a curtain, screen, or door

3 Before placing bedpan, lowers head of bed

4 Puts on clean gloves before placing bedpan under client

5 Places bedpan correctly under client’s buttocks

6 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

7 After positioning client on bedpan and removing

gloves, raises head of bed

8 Toilet tissue is within reach

9 Hand wipe is within reach and client is instructed to

clean hands with hand wipe when nished

10 Signaling device within reach and client is asked to

signal when nished

11 Puts on clean gloves before removing bedpan

12 Head of bed is lowered before bedpan is removed

13 Ensures client is covered except when placing and

removing bedpan

14 Empties and rinses bedpan and pours rinse into toilet

15 Places bedpan in designated dirty supply area

16 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

17 Signaling device is within reach and bed is in low

position

SKILL 5 — CLEANS UPPER OR LOWER

DENTURE

1 Puts on clean gloves before handling denture

2 Bottom of sink is lined and/or sink is partially lled

with water before denture is held over sink

3 Rinses denture in moderate temperature running water

before brushing them

4 Applies denture toothpaste to toothbrush

5 Brushes all surfaces of denture

6 Rinses all surfaces of denture under moderate

temperature running water

7 Rinses denture cup and lid

8 Places denture in denture cup with moderate

temperature water/solution and places lid on cup

Skill continues

SKILL

NOT

TESTED

9 Rinses toothbrush and places in designated toothbrush

basin/container

10 Maintains clean technique with placement of

toothbrush and denture

11 Sink liner is removed and disposed of appropriately

and/or sink is drained

12 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

SKILL 6 — COUNTS AND RECORDS RADIAL

PULSE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Places ngertips on thumb side of client’s wrist to locate

radial pulse

3 Count beats for one full minute

4 Signaling device is within reach

5 Before recording, washes hands

6 Records pulse rate within plus or minus 4 beats of

evaluator’s reading

SKILL 7 — COUNTS AND RECORDS

RESPIR ATIONS

1 Explains procedure (for testing purposes), speaking

clearly, slowly, and directly, maintaining face-to-face

contact whenever possible

2 Counts respirations for one full minute

3 Signaling device is within reach

4 Before recording, washes hands

5 Records respiration rate within plus or minus 2

breaths of evaluator’s reading

SKILL 8 — DONNING AND REMOVING PPE

(GOWN AND GLOVES)

1 Picks up gown and unfolds

2 Facing the back opening of the gown places arms

through each sleeve

3 Fastens the neck opening

4 Secures gown at waist making sure that back of clothing

is covered by gown (as much as possible)

5 Puts on gloves

Skill continues

6 Cus of gloves overlap cus of gown

7 Before removing gown, with one gloved hand,

grasps the other glove at the palm, remove glove

8 Slips ngers from ungloved hand underneath cu of

remaining glove at wrist, and removes glove turning

it inside out as it is removed

9 Disposes of gloves into designated waste container

without contaminating self

10 After removing gloves, unfastens gown at waist and

neck

11 After removing gloves, removes gown without touching

outside of gown

12 While removing gown, holds gown away from body

without touching the oor, turns gown inward and

keeps it inside out

13 Disposes of gown in designated container without

contaminating self

14 After completing skill, washes hands

SKILL 9 — DRESSES CLIENT WITH AFFECTED

(WEAK) RIGHT ARM

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Asks which shirt he/she would like to wear and dresses

him/her in shirt of choice

4 Avoids overexposure of client by ensuring client’s chest

is covered

5 Removes gown from the left (unaected) side rst,

then removes gown from the right (aected/weak) side

6 Before dressing client, disposes of gown into soiled

linen container

7 Assists to put the right (aected/weak) arm through

the right sleeve of the shirt before placing garment

on left (unaected) arm

8 While putting on shirt, moves body gently and

naturally, avoiding force and over-extension of limbs

and joints

9 Finishes with clothing in place

10 Signaling device is within reach and bed is in low

position

11 After completing skill, washes hands

SKILL 10 — FEEDS CLIENT WHO CANNOT

FEED SELF

1 Explains procedure to client, speaking clearly, slowly,

and directly, maintaining face-to-face contact whenever

possible

2 Before feeding, looks at name card on tray and asks

client to state name

3 Before feeding client, client is in an upright sitting

position (75-90 degrees)

4 Places tray where the food can be easily seen by client

5 Candidate cleans client’s hands before beginning

feeding

6 Candidate sits in a chair facing client during feeding

7 Tells client what foods and beverage are on tray

8 Asks client what he/she would like to eat rst

9 Using spoon, oers client one bite of each type of food

on tray, telling client the content of each spoonful

10 Oers beverage at least once during meal

11 Candidate asks client if they are ready for next bite of

food or sip of beverage

12 At end of meal, candidate cleans client’s mouth and

hands

13 Removes food tray

14 Leaves client in upright sitting position (75-90 degrees)

with signaling device within client’s reach

15 After completing skill, washes hands

SKILL 11 — GIVES MODIFIED BED BATH (FACE

AND ONE ARM, HAND AND UNDERARM)

1 Explains procedure, speaking clearly, slowly, and directly,

maintaining face-to-face contact whenever possible

2 Privacy is provided with a curtain, screen, or door

3 Removes gown and places directly in soiled linen

container while ensuring client’s chest and lower body

is covered

4 Before washing, checks water temperature for safety

and comfort and asks client to verify comfort of water

5 Puts on clean gloves before washing client.

6 Beginning with eyes, washes eyes with wet washcloth

(no soap), using a dierent area of the washcloth for

each stroke, washing inner aspect to outer aspect

then proceeds to wash face

Skill continues

7 Dries face with dry cloth towel/washcloth

8 Exposes one arm and places cloth towel underneath arm

9 Applies soap to wet washcloth

10 Washes ngers (including ngernails), hand, arm, and

underarm keeping rest of body covered

11 Rinses and dries ngers, hand, arm, and underarm

12 Moves body gently and naturally, avoiding force and

over-extension of limbs and joints

13 Puts clean gown on client

14 Empties, rinses, and dries basin

15 Places basin in designated dirty supply area

16 Disposes of linen into soiled linen container

17 Avoids contact between candidate clothing and used

linens

18 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

19 Signaling device is within reach and bed is in low

position

SKILL 12* — MEASURES AND RECORDS

ELECTRONIC BLOOD PRESSURE

*STATE SPECIFIC (EVALUATOR: DO NOT

SUBSTITUTE THIS SKILL FOR SKILL 23 ‘MANUAL

BLOOD PRESSURE’)

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Has client assume a comfortable lying or sitting position

4 Client’s arm is positioned at level of heart with palm up

and upper arm is exposed

5 Selects appropriate cu size

6 Feels for brachial artery on inner aspect of arm, at bend

of elbow

7 Places blood pressure cu snugly on client’s upper arm

and sensor/arrow is over the brachial artery site

8 Turns on the machine and ensures device is functioning.

If the machine has dierent settings for infants, children,

and adults, selects the appropriate setting

9 Pushes start button. If cu inates to more than 200

mm Hg then stops machine and uses cu on client’s

other arm

Skill continues

SKILL

NOT

TESTED

10 Waits until the blood pressure reading appears on the

screen and for the cu to deate, then removes the cu

11 Signaling device is within reach

12 Before recording, washes hands

13 After obtaining reading using BP cu, records both

systolic and diastolic pressures exactly as displayed

on the digital screen

SKILL 13 — MEASURES AND RECORDS

URINARY OUTPUT

1 Puts on clean gloves before handling bedpan

2 Pours the contents of the bedpan into measuring

container without spilling or splashing urine outside of

container

3 Rinses bedpan and pours rinse into toilet

4 Measures the amount of urine at eye level with

container on at surface (if between measurement

lines, round up to nearest 25 ml/cc)

5 After measuring urine, empties contents of measuring

container into toilet

6 Rinses measuring container and pours rinse into toilet

7 Before recording output, removes and disposes

of gloves (without contaminating self) into waste

container and washes hands

8 Records contents of container within plus or minus

25 ml/cc of evaluator’s reading

SKILL 14 — MEASURES AND RECORDS

WEIGHT OF AMBULATORY CLIENT

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Client has non-skid shoes/footwear on before walking

to scale

3 Before client steps on scale, candidate sets scale to zero

4 Asks client to step on center of scale and obtains

client’s weight

5 Asks client to step o scale

6 Before recording, washes hands

7 Records weight based on indicator on scale. Weight

is within plus or minus 2 lbs of evaluator’s reading

(If weight recorded in kg weight is within plus or

minus 0.9 kg of evaluator’s reading)

SKILL NOT

TESTED

SKILL 15 — PERFORMS MODIFIED PASSIVE

RANGE OF MOTION (PROM) FOR ONE KNEE

AND ONE ANKLE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Ensures that client is supine in bed and instructs client

to inform candidate if pain is experienced during

exercise

4 While supporting the leg at knee and ankle, bends

the knee and then returns leg to client’s normal

position (exion/extension) (AT LEAST 3 TIMES

unless pain is verbalized). Moves joints gently,

slowly and smoothly through the range of motion,

discontinuing exercise if client verbalizes pain.

5 While supporting the foot and ankle close to the

bed, pushes/pulls foot toward head (dorsiexion),

and pushes/pulls foot down, toes point down

(plantar exion) (AT LEAST 3 TIMES unless

pain is verbalized). Moves joints gently, slowly

and smoothly through the range of motion,

discontinuing exercise if client verbalizes pain.

6 Signaling device is within reach and bed is in low

position

7 After completing skill, washes hands

SKILL 16 — PERFORMS MODIFIED PASSIVE

RANGE OF MOTION (PROM) FOR ONE

SHOULDER

1 Explains procedure, speaking clearly, slowly, and directly,

maintaining face-to-face contact whenever possible

2 Privacy is provided with a curtain, screen, or door

3 Instructs client to inform candidate if pain experienced

during exercise

4 While supporting arm at the elbow and at the wrist,

raises client’s straightened arm from side position

upward toward head to ear level and returns arm

down to side of body (exion/extension) (AT

LEAST 3 TIMES unless pain is verbalized). Moves

joint gently, slowly and smoothly through the range

of motion, discontinuing exercise if client verbalizes

pain.

Skill continues

5 While supporting arm at the elbow and at the wrist,

moves client’s straightened arm away from the side

of body to shoulder level and returns to side of

body (abduction/adduction) (AT LEAST 3 TIMES

unless pain is verbalized). Moves joint gently,

slowly and smoothly through the range of motion,

discontinuing exercise if client verbalizes pain.

6 Signaling device is within reach and bed is in low

position

7 After completing skill, washes hands

SKILL 17 — POSITIONS ON SIDE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before turning, lowers head of bed

4 Raises side rail on side to which body will be turned

5 Candidate assists client to slowly roll onto side toward

raised side rail

6 Places or adjusts pillow under head for support

7 Candidate repositions arm and shoulder so that client

is not lying on arm

8 Supports top arm with supportive device

9 Places supportive device behind client’s back

10 Places supportive device between legs with top knee

exed; knee and ankle supported

11 Signaling device is within reach and bed is in low

position

12 After completing skill, washes hands

SKILL 18 — PROVIDES CATHETER CARE FOR

FEMALE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before washing, checks water temperature for safety

and comfort and asks client to verify comfort of water

4 Puts on clean gloves before washing

5 Places linen protector under perineal area including

buttocks before washing

Skill continues

6 Exposes area surrounding catheter (only exposing client

between hip and knee)

7 Applies soap to wet washcloth

8 While holding catheter at meatus without tugging,

cleans at least four inches of catheter from meatus,

moving in only one direction, away from meatus,

using a clean area of the washcloth for each stroke

9 While holding catheter at meatus without tugging,

using a clean washcloth, rinses at least four inches

of catheter from meatus, moving only in one

direction, away from meatus, using a clean area of

the washcloth for each stroke

10 While holding catheter at meatus without tugging,

dries at least four inches of catheter moving away from

meatus using a dry cloth towel/washcloth

11 Empties, rinses, and dries basin

12 Places basin in designated dirty supply area

13 Disposes of used linen into soiled linen container and

disposes of linen protector appropriately

14 Avoids contact between candidate clothing and used

linen

15 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

16 Signaling device is within reach and bed is in low

position

SKILL 19 — PROVIDES FOOT CARE ON ONE

FOOT

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before washing, checks water temperature for safety and

comfort and asks client to verify comfort of water

4 Basin is in a comfortable position for client and on

protective barrier

5 Puts on clean gloves before washing foot

6 Client’s bare foot is placed into the water

7 Applies soap to wet washcloth

8 Lifts foot from water and washes foot (including

between the toes)

Skill continues

9 Foot is rinsed (including between the toes)

10 Dries foot (including between the toes) with dry cloth

towel/washcloth

11 Applies lotion to top and bottom of foot (excluding

between the toes) removing excess with a towel/

washcloth

12 Supports foot and ankle during procedure

13 Empties, rinses, and dries basin

14 Places basin in designated dirty supply area

15 Disposes of used linen into soiled linen container

16 Removes and disposes of gloves (without contaminating

self) into waste container and washes hands

17 Signaling device is within reach

SKILL 20 — PROVIDES MOUTH CARE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before providing mouth care, client is in upright sitting

position (75-90 degrees)

4 Puts on clean gloves before cleaning mouth

5 Places cloth towel across chest before providing mouth

care

6 Secures cup of water and moistens toothbrush

7 Before cleaning mouth, applies toothpaste to

moistened toothbrush

8 Cleans mouth (including tongue and all surfaces of

teeth), using gentle motions

9 Maintains clean technique with placement of

toothbrush

10 Candidate holds emesis basin to chin while client

rinses mouth

11 Candidate wipes mouth and removes clothing

protector

12 Disposes of used linen into soiled linen container

13 Rinses toothbrush and empties, rinses, and dries basin

14 Removes and disposes of gloves (without

contaminating self) into waste container and washes

hands

15 Signaling device is within reach and bed is in low

position

SKILL 21 — PROVIDES PERINEAL CARE

(PERI-CARE) FOR FEMALE

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before washing, checks water temperature for safety

and comfort and asks client to verify comfort of water

4 Puts on clean gloves before washing perineal area

5 Places pad/ linen protector under perineal area

including buttocks before washing

6 Exposes perineal area (only exposing between hips and

knees)

7 Applies soap to wet washcloth

8 Washes genital area, moving from front to back,

while using a clean area of the washcloth for each

stroke

9 Using clean washcloth, rinses soap from genital

area, moving from front to back, while using a clean

area of the washcloth for each stroke

10 Dries genital area moving from front to back with dry

cloth towel/washcloth

11 After washing genital area, turns to side, then washes

rectal area moving from front to back using a clean area

of washcloth for each stroke.

12 Using clean washcloth, rinses soap from rectal area,

moving from front to back, while using a clean area of

the washcloth for each stroke

13 Dries rectal area moving from front to back with dry

cloth towel/washcloth

14 Repositions client

15 Empties, rinses, and dries basin

16 Places basin in designated dirty supply area

17 Disposes of used linen into soiled linen container and

disposes of linen protector appropriately

18 Avoids contact between candidate clothing and used

linen

19 Removes and disposes of gloves (without

contaminating self) into waste container and washes

hands

20 Signaling device is within reach and bed is in low

position

Skill continues

SKILL 22 — TRANSFERS FROM BED TO

WHEELCHAIR USING TRANSFER BELT

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Privacy is provided with a curtain, screen, or door

3 Before assisting to stand, wheelchair is positioned

alongside of bed, at head of bed facing foot or foot of

bed facing head

4 Before assisting to stand, footrests are folded up or

removed

5 Before assisting to stand, locks wheels on wheelchair

6 Before assisting to stand, bed is at a safe level

7 Before assisting to stand, checks and/or locks bed

wheels

8 Before assisting to stand, client is assisted to a

sitting position with feet at on the oor

9 Before assisting to stand, client is wearing shoes

10 Before assisting to stand, applies transfer belt securely

at the waist over clothing/gown

11 Before assisting to stand, provides instructions to

enable client to assist in transfer including prearranged

signal to alert when to begin standing

12 Stands facing client positioning self to ensure safety of

candidate and client during transfer. Counts to three

(or says other prearranged signal) to alert client to

begin standing

13 On signal, gradually assists client to stand by grasping

transfer belt on both sides with an upward grasp

(candidates hands are in upward position) and

maintaining stability of client’s legs by standing knee to

knee, or toe to toe with the client

14 Assists client to turn to stand in front of wheelchair

with back of client’s legs against wheelchair

15 Lowers client into wheelchair

16 Positions client with hips touching back of wheelchair

and transfer belt is removed

17 Positions feet on footrests

18 Signaling device is within reach

19 After completing skill, washes hands

Skill continues

SKILL 23* — MEASURES AND RECORDS

MANUAL BLOOD PRESSURE

*STATE SPECIFIC (EVALUATOR: DO NOT

SUBSTITUTE THIS SKILL FOR SKILL 12

‘ELECTRONIC BLOOD PRESSURE’)

1 Explains procedure, speaking clearly, slowly, and

directly, maintaining face-to-face contact whenever

possible

2 Before using stethoscope, wipes bell/diaphragm and

earpieces of stethoscope with alcohol

3 Client’s arm is positioned with palm up and upper arm

is exposed

4 Feels for brachial artery on inner aspect of arm, at bend

of elbow

5 Places blood pressure cu snugly on client’s upper arm,

with sensor/arrow over brachial artery site

6 Earpieces of stethoscope are in ears and bell/diaphragm

is over brachial artery site

7 Candidate inates cu between 160mm Hg to 180

mm Hg. If beat heard immediately upon cu deation,

completely deate cu. Re-inate cu to no more than

200 mm Hg

8 Deates cu slowly and notes the rst sound (systolic

reading), and last sound (diastolic reading) (If rounding

needed, measurements are rounded UP to the nearest 2

mm of mercury)

9 Removes cu

10 Signaling device is within reach

11 Before recording, washes hands

12 After obtaining reading using BP cu and

stethoscope, records both systolic and diastolic

pressures each within plus or minus 8 mm of

evaluator’s readings

While a formal nurse aide “scope of practice”

does not exist, these skills addressed as part of the

NATCEP program constitute the range of accept-

able duties that may be assigned to a nurse aide

and that a nurse aide will be deemed competent to

perform. Duties inherent to another professional

scope of practice, such as those associated with a

Licensed Practical Nurse or Registered Nurse, are

deemed inappropriate for a nurse aide to perform.

SCORE REPORTING

EX AM RESULTS

You will receive a notication email from CNA365 when

a new exam score has been posted to your online account.

To access your score report, please login to your CNA365

account by clicking the “CNA365 Login” button on the

top of the Pennsylvania nurse aide website page at www.cre-

dentia.com/test-takers/pa Score reports are generally avail-

able within a few hours after a testing event is completed

for the day. If it has been more than 24 hours and you are

unable to view your score report in CNA365, please contact

customer service at 800-457-6752.

SCORE REPORTING

Credentia will provide you with your ocial examination

results within a few hours after a testing event is completed

for the day. Score reports are provided online and are avail-

able for you to print or download. Examinations results

will not be given over the telephone nor can they be sent by

Credentia to your employer.

FAILING

If you fail the Written (or Oral) Examination or the Skills

Evaluation, your Score Report will provide you with infor-

mation on how to re-take either or both parts.

If you fail either part of the NNAAP Examination three

(3) times, you will need to complete another train-

ing program and re-take BOTH parts of the NNAAP

Examination, not just the part that was failed. In addi-

tion, if you were scheduled to take the exam 3 times and

did not become eligible for enrollment on the nurse aide

registry, either as a result of failing the exam or absence(s),

you will need to re-train. If you are either an E3 or an E4

candidate (see page 2), you have ONLY ONE attempt to

pass the examination. If you fail, you MUST re-train and

re-apply under eligibility route E0.

See Registration and Scheduling for more details.

HOW TO READ A FAILING

SCORE REPORT

If you do not pass the Skills Evaluation, you will

receive a Failing Score Report. e score report will

list the ve (5) skills that you performed and a score of

Satisfactory or Unsatisfactory for each skill. Any skill with

an Unsatisfactory result is considered a failed skill. You

must receive a Satisfactory result on all ve (5) skills in

order to pass the Skills Evaluation.

Use your Failing Score Report as an aid in studying to

re-take the Skills Evaluation. A failed skill will show the

reason for the failure. You may not have performed the

steps of a skill correctly, or you may have forgotten a step,

especially a Critical Element Step.

e Failing Score Report will list steps that were missed or

incorrect—look for numbers printed directly under a skill

marked Unsatisfactory. A list of all the skills and the steps

needed for each skill can be found in this handbook. Find

the skill you failed, and study the steps, especially steps

listed as Unsatisfactory on the score report.

In the example below, a candidate received a result of

Unsatisfactory on the skill Hand Hygiene. e numbers

1, 5, and 10 printed below the skill refer to steps that

were missed or performed incorrectly. To study for re-

taking the Skills Evaluation, this candidate should turn

to the Skills Listing in this handbook, look for the Hand

Hygiene skill, and review all the steps, especially steps

1, 5, and 10.

Pennsylvania NNAAP

Examination Results

Exam: Skills Result: Fail

Skills Performance:

Hand Hygiene

1, 5, 10

Unsatisfactory

Provides Mouth Care Satisfactory

Measures and Records Blood

Pressure

Satisfactory

Puts One Knee-High

Elastic Stocking on Client

Satisfactory

Assists Client to Ambulate

using transfer belt

Satisfactory

A sample of a Failing Score Report

PASSING

Once you have passed both the Written (or Oral)

Examination and the Skills Evaluation, your name will

be placed on the Pennsylvania Nurse Aide Registry. You

will receive an email from CNA365 conrming your

placement on the Pennsylvania Nurse Aide Registry.

Your electronic Registry Card (also known as a Notice of

Enrollment) will be attached to the email. At any time,

you may login to your CNA365 account to download an

electronic Registry Card. You must show this card to your

employer. Do not make any changes to your Registry

Card. Any changes to the Registry Card could aect

your status as a nurse aide.

In addition, a registry card will be mailed to you by

Credentia and will arrive approximately three (3) weeks

after you successfully complete both the Written (or Oral)

Examination and the Skills Evaluation.

You must successfully pass both parts of the NNAAP

Examination within two (2) years of your training pro-

gram completion date in order to be eligible for placement

on the Pennsylvania Nurse Aide Registry.

Note: Although you were required to submit to a back-

ground check in order to participate in the nurse aide

training and testing program, employers must conduct

routine background checks at the time of employment

to ensure your eligibility to work in their facility (http://

www.aging.state.pa.us/psonlinetraining/cwp/view.

asp?a=3&Q=242763). Consistent with 35 PS §10225.506,

facilities may employ you on a provisional basis for a single

period not to exceed thirty (30) days for candidates who

have resided in Pennsylvania for two years immediately

preceding the date of the application for employment; and,

for applicants who have not been a resident of Pennsylvania

for two years immediately preceding the date of the applica-

tion for employment, a period of ninety (90) days, if all the

following conditions are met:

1) e applicant has applied for the information

required under the Act and the applicant provides a

copy of the appropriate completed request forms to

the administrator.

2) e facility has no knowledge of information per-

taining to the applicant which would disqualify

applicant from employment pursuant to the Act,

subject to 18 Pa. C.S. § 4911 (relating to tampering

with public records or information).

3) e applicant swears or arms in writing that

applicant is not disqualied from employment

under the Act.

GRIEVANCE PROCESS

All grievances must be in writing and submitted through

the online system. e candidate must provide as much

detail as possible in the grievance form. e grievance

must be submitted within 30 days of the candidate’s exam

date. After receipt of the grievance form, the complaint

will be investigated.

Once the investigation is complete, Credentia will send

email correspondence back to the candidate informing

him/her of the outcome of the investigation. If the griev-

ance is substantiated, the candidate will be allowed to

retest at no additional cost.

For details on how to submit a grievance, visit www.

credentia.com/test-takers/pa and click on “Grievances” in

the Resources section of the webpage. You will receive a

response within 30 days of receipt.

THE REGISTRY

REGISTRY RENEWAL

Once you are listed on the Registry, Credentia will send

electronic renewal reminders to your email address and

will mail a notication of continued enrollment to your

home address (as listed on the Registry) approximately

ninety (90) days prior to expiration of your enrollment.

To be eligible for continued enrollment, you are required

to work as a nurse aide at least one documented day (i.e.

8 consecutive hours) for pay in an approved facility

(such as a nursing home, personal care home, hospital,

home health setting or intermediate care facility) during

the previous twenty- four (24) months. Self-employment,

private-duty, or employment in doctors’ oces are not

acceptable forms of work experience for continued

enrollment.

Note: 42 CFR 483.75(e)(8) requires that facilities

provide at least 12 hours of training to their nurse

aides based on needs identied in yearly perfor-

mance reviews. PA State Code 201.20 outlines a

list of required yearly in-service topics that must be

provided to facility personnel includ- ing: Infection

Prevention and Control; Fire Prevention and Safety;

Accident Prevention; Disaster Preparedness; Resident

Condential Information; Resident Psychosocial Needs;

Restorative Nursing Techniques; Resident Rights,

including Property Rights; Privacy; Preservation of

Dignity; Abuse Prevention; and Reporting of Abuse.

While these are requirements associated with State

and Federal Long-Term Care regulations, they are not

require- ments inherent to the Nurse Aide Registry and

have no impact on registry renewal.

Upon successfully renewing your status on the Registry,

you will receive an electronic Registry Card by email and

Credentia will also mail a new Registry Card (also known

as a Notice of Enrollment), which will be valid for the next

twenty-four (24) months. It is important that your cur-

rent address is always listed on the Nurse Aide Registry to

ensure that you get important documentation regarding

your enrollment.

CNA365 ONLINE RENEWAL

Credentia’s CNA365 system allows for an online registra-

tion renewal process. CNA365 allows individuals to:

• Renew their nurse aide registration

• Update their address (during and outside the

renewal registration process)

• Initiate name and social security number

changes

For detailed instructions how to renew online, visit www.

credentia.com/test-takers/pa and select “How to Renew

Your Registration” in the Nurse Aide Registry Resource

section of the webpage.

CHANGE OF ADDRESS, NAME, OR SSN

The Registry must be kept informed of your current

address and name.

If you change your address or your name at any time after

you are placed on the Registry, you MUST inform the

Registry in order to keep your enrollment information

up to date.

To change your address or name, login to your CNA365

account and select “Manage Prole”. en select the “Edit

Prole” button to change your address. If you need to

change your name or Social Security Number (SSN), you

will need to select the “Correction Form” button to submit

a change request for Credentia review. You must upload

written documentation (copy of a marriage certicate, a

divorce decree, or another ocial document) to support

your name change or SSN request.

LOST REGISTRY CARDS

If you lose your Registry Card (also known as a Notice

ofEnrollment), you can login to your CNA365 account to

download an electronic Registry Card. If you would like

a paper copy of your Registry Card, you may submit a

Duplicate Registry Card request online in your CNA365

account. Alternatively, you may sending the Duplicate

Registry Card Request Form in the back of this hand-

book to Credentia. ere is no charge for this service.

RE-ACTIVATING INACTIVE STATUS

Under federal requirements, enrollment on the Registry is

no longer valid for any individual who has had a lapse of

twenty-four (24) consecutive months or more in the per-

formance of paid nursing-related services. It is important

to update your employment history on the Pennsylvania

Nurse Aide Registry. You will receive notication regard-

ing continued enrollment at your home address listed on

the Registry. Failure to inform the Registry of a change in

employment may jeopardize your enrollment status.

If you were previously on the Registry but you have not

worked (providing nursing-related services) for a period of

twenty-four (24) consecutive months or more, you become

“inactive” and are assigned a “denial of renewal” status.

As a formerly active member of the Registry, you have one

opportunity to take and successfully complete (pass) the

NNAAP Examination. If you successfully complete (pass)

the NNAAP Examination, your status will change to

“renewed” on the Nurse Aide Registry. If you are unsuc-

cessful in passing the examination, you are required to re-

train before re-testing. You may not be employed as a nurse

aide until you have ocial notication of enrollment or a

renewed active status. Employers are NOT required to pay

the “renewal” examination fee; however, employers MUST

pay when a reimbursement letter is presented.

RECIPROCITY

If you are a nurse aide currently listed on another

state’s nurse aide (or equivalent) registry as active and in

good standing (according to federal nursing home nurse

aide statutes), and you are seeking enrollment on the

Pennsylvania Nurse Aide Registry, you will need to submit

a reciprocity application. Visit www.credentia.com/test-

takers/pa for further information including specic steps

on how to create a CNA365 online account and submit a

reciprocity application.

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

1. What

types of

background

checks are

required for

nurse aide

training?

A PA State Police Criminal History

Record Information (CHRI) report is

required for all nurse aides who have

been PA residents for at least two

consecutive years and a PA-CHRI

and FBI report for students who have

not resided in PA for the last 2

consecutive years. All reports must be

submitted PRIOR to enrollment in a

training class.

Act 169

35 P.S. §10225.502(a)(1)&(2)

2. Can a

nurse aide

work for any

period of time

while await-

ing a criminal

background

check clear-

ance?

In-state residents may work for 30

days while awaiting PA background

clearance but may not enter a train-

ing class until the background check

is completed.

Act 169 of 1996

35 P.S. §10225.506

Out-of-state residents may work

for 90 days while awaiting a FBI

background clearance but may not

enter a training class until all back-

ground checks are completed.

(provided 5 specified conditions

are met)

3. What are

the require-

ments for

renewal of

a nurse aide

registry?

A nurse aide must work as a nurse

aide for a minimum of one docu-

mented day (i.e. 8 consecutive hours)

for pay in an approved facility type

during each twenty-four (24)-month

period covered by the registry.

42 CFR §483.75(e)(7)

F496

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

4. How

many hours

of training

are required

for eligibility

to take the

competency

exam?

PA is an 80-hour state of which 37.5

hours must be supervised clinical

experience.

42CFR§4842CFR§483.152(a)(1)

5. How

much can a

nurse aide be

charged for

nurse aide

training and

competency

evaluation

program?

Nothing if employed or has an

offer of employment on start date

of program.

42CFR§483.152(c)(1)

If a nurse aide gains employment

or offer of employment within 12

months of completing a program, the

nursing facility must reimburse on

a pro-rated basis for the period the

individual is employed as a nurse aide.

42CFR§483.152(c)(2)

6. How long

can a nurse

aide work in

a facility prior

to enrollment

on the nurse

aide registry?

A nurse aide may work for four (4)

months or 120 days while participat-

ing in a nurse aide training and/or

competency evaluation program.

42CFR§483.75(e)(5)(i) and (ii)

7. What is

considered

an acceptable

work setting

for renewal of

my nurse aide

registry?

Employment of at least one docu-

mented day (i.e. 8 consecutive hours)

for pay in nursing homes, personal

care homes, hospitals, nursing agen-

cies or intermediate care facilities are

appropriate for renewal. Private duty,

self-employment, and employment

in doctor’s offices is not sufficient for

renewal credit.

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

8. If I was

annotated on

the Registry,

how can I be

reinstated?

Only those annotated for “neglect” may

request reinstatement considerations

after one (1) full year from the date of

annotation on the Registry. The only

other consideration will be given to

those that a court of law overturned the

Department’s decision.

42 U.S.C. 1396r §1919(g)(1)(D)

9. How do

I bring my

registry up

to date if I

lapsed?

Nurse aides have one opportunity to

re-test to update a lapsed registry or

they may provide proof of employ-

ment for pay of at least one docu-

mented day (i.e. 8 consecutive hours)

during each 24-month registry

period. If you are lapsed on another

state registry, you have to be updated

on your original state registry to be

eligible for reciprocity.

10. What

duties fall

under a nurse

aide’s scope of

practice?

Nurse aides do not have a formal

“scope of practice”; however, they

should only be performing those

duties learned during their NA train-

ing & testing program. Duties cov-

ered under a “professional scope of

practice” should only be performed

by a licensed professional in that

respective field.

42CFR§483.75(e)

11. How

many training

hours must I

have annually

to renew my

registry?

There are no “training requirements”

to renew your registry. Rather, the

nursing homes administration is

required to provide nurse aides a

minimum of twelve (12) hours of

in-service education each year based

on the results of yearly performance

evaluations.

42CFR§483.75(e)(8)

F497

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

12. What

yearly train-

ing topics

must be pro-

vided to nurse

aides?

Nursing home administrations

must conduct yearly in-service

training on the following topics:

Infection Prevention and Control,

Fire Prevention & Safety, Accident

Prevention, Disaster Preparedness,

Resident Confidential Information,

Resident Psychosocial Needs,

Restorative Nursing Techniques,

Resident Rights, including Property

Rights, Privacy, Preservation of

Dignity, Abuse Prevention, Reporting

of Resident Abuse. This list of

required topics may be accessed via

the following link:

http://www.pacode.com/secure/

data/028/chapter201/s201.20.html

28 PA Code §201.20

Additional yearly training must address

areas of weakness as determined in the

nurse aides performance review.

42CFR483.75(e)(7)(ii)

13. If a nurse

aide was

annotated in

another state,

can she or he

work in PA?

Facilities are required to verify that

nurse aides are in good standing

on all other state registries prior

to allowing them to work in

that capacity.

42CFR§483.75(e)(6)

F496

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PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

14. How do I

obtain a copy

of the Nurse

Aide Registry

list?

Send a request for the information

to:

Credentia

Nurse Aide Operations

Attn: PA Program Manager

3 Bala Plaza West – Suite 300

Bala Cynwyd, PA 19004

or call 800-852-0518. The list will

be sent electronically.

15. I was

sent home

because an

allegation of

abuse, neglect

or misap-

propriation of

property was

made against

me. What

does this

mean?

Any time an allegation of abuse,

neglect, or misappropriation of resi-

dent property is made, the facility

is legally responsible to investigate

and take whatever personnel action

they deem necessary consistent

with their local policy. However,

only the Department of Health

can take action against the nurse

aide’s Registry; therefore, the facil-

ity investigation must be forwarded

to the DOH for review and action

as appropriate. If the DOH initi-

ates action, an Order to Show Cause

will be issued. An Annotation Letter

will be sent after due process is pro-

vided and a final decision made. If

no action is taken, the nurse aide

remains in good standing on the

Registry and prospective employ-

ers will see nothing more than that

when reviewing your Registry status.

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

16. I have

a prior

conviction

on record.

Will it

prevent me

from being

able to work

in nursing

homes?

No. At this time, the prohibitive list

does not prevent a nurse aide from

being employed at a nursing home.

Employment in a nursing home with

a criminal conviction would be up to

the facility and their policy. Nursing

homes are mandated by Federal

Regulations to complete pre-employ-

ment background checks.

17. Does it

make a differ-

ence re: reim-

bursement

if a facility

is Medicare/

Medicaid/

or dually

certified?

The Registry regulations clearly

specify that a nurse aide is not to

bear the expense of NATCEP partic-

ipation if employment requirements

are met.

18. If I

completed

NATCEP

training but

failed the

test three (3)

times, can I

retrain and

test again?

If an individual fails the state com-

petency examination three times,

they may re-train and have another

three opportunities.

Some facilities will re-train if the

individual is a good employee.

However, the individual may re-train

at any approved program.

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

19. If I

worked in a

facility 60

days while in

a NATCEP

program and

got fired, how

many days

can I work in

another facili-

ty while work-

ing toward

Registry

status?

Nurse aide trainees have two (2)

years after completion of nurse aide

training to take the state competency

examination. The 120 days start over

every time the nurse aide trainee

changes employers.

20. I have

been on active

duty in the

military and

have not been

able to work

the required

eight (8) con-

secutive hours

for pay during

the two year

registration

period. Will

my military

service count

for renewal?

Service in the military may count if

you performed the duties inherent

in the intent of the regulation. For

military service time to count toward

renewal, you must have performed

duties associated with helping a care

dependent population with activities

of daily living in a supervised setting.

This must be able to be officially

verified in writing through your

Commanding Officer.

21. My

address

changed

and I did

not receive

my renewal

application

through the

mail. Can I

still renew my

registration

on-line?

If your registration has not yet

lapsed, you may contact (800) 852-

0518 and request a renewal appli-

cation be re-mailed to your new

address. You may then use the log-in

information to update your registry

on-line. However, if your registration

has already lapsed, you will not be

able to renew on-line.

Table continues

PA NURSE AIDE REGISTRY —

FREQUENTLY ASKED QUESTIONS

QUESTION ANSWER AND REFERENCE

(WHERE APPLICABLE)

22. I lost my

renewal ID

or password,

what should

I do?

You must contact (800) 852-0518 to

request a new renewal application

be mailed to you. Renewal ID’s and

password information will not be

able to be provided via telephone.

Pennsylvania

Nurse Aide

Duplicate Registry Card Request

APPENDIX

DIRECTIONS: You may use this form to request Credentia to send a duplicate copy of your Registry Card (also known as a Notice

of Enrollment) to you if you have lost your copy or if you want your Registry Card to reflect a name or address

change. If your name has changed, you MUST provide supporting documentation, such as a copy of a marriage

certificate, a divorce decree, or another official document. Please print or type all information on the reverse side of

this form, or your request will be returned.

SEND TO: PA Nurse Aide Registry

Credentia

PO Box 13785

Philadelphia, PA 19101-3785

PLEASE COMPLETE OTHER SIDE OF THIS FORM

Please complete the following form with your current name and address. All information must be complete and

accurate to ensure proper processing.

Name ________________________________________________________________________________________________________________

Street ________________________________________________________________________________________________________________

City ______________________________________________________________________ State ____________Zip_______________________

Tel. (______)____________________________________ Social Security Number ________________________________________

If the above information was different at the time you were tested, please indicate original information.

Name ________________________________________________________________________________________________________________

Street ________________________________________________________________________________________________________________

City ______________________________________________________________________ State ____________Zip_______________________

Tel. (______)___________________________________

I hereby authorize Credentia to send to me at the address above a duplicate copy of my Registry Card.

Your Signature _____________________________________________________________________ Date ______________________________

PLEASE COMPLETE BOTH SIDES OF THIS FORM