CNA Classes & Programs in Delaware

Before starting your training, it's important to understand exactly what Delaware requires to become a Certified Nursing Assistant (CNA). In Delaware, nursing assistants must obtain certification through the Delaware Department of Health and Social Services (DHSS), whose Division of Health Care Quality (DHCQ) oversees CNA training, testing, and the Delaware Nurse Aide Registry. Meeting these requirements allows you to complete the required training and competency examinations, receive your Delaware CNA certification, and work in nursing homes, hospitals, assisted living facilities, home care agencies, and other healthcare settings throughout the state.

Eligibility

• Program enrollment: The standard pathway requires completion of a Delaware Division of Health Care Quality-approved Certified Nursing Assistant training program. Approved programs are offered through nursing facilities, vocational schools, community colleges, high schools, and other authorized training providers. All CNA training programs must receive DHCQ approval before providing instruction.
• Age and admission requirements: Each training program sets its own admission requirements, such as a minimum age, education level, or reading and communication skills. Several of Delaware's approved programs are run by high schools. Confirm the requirements with the program you choose.
• Health screenings and background checks: Delaware CNA training programs must comply with the state's immunization and tuberculosis screening requirements. Students must meet applicable vaccination requirements before participating in clinical training and undergo baseline tuberculosis screening before providing clinical services. To work in a nursing home or other long-term care facility, or for a home health agency, Delaware law requires a fingerprint-based state and FBI criminal background check and a drug test, run through DHCQ's Background Check Center. Training programs may also set their own checks. Certain criminal histories or findings of resident abuse, neglect, or financial exploitation may affect an individual's eligibility for employment or continued certification.
• Alternative pathways: Delaware recognizes several alternatives to completing a separate standard CNA training program. Current nursing students who have successfully completed a Fundamentals or Basic Nursing course and the required supervised clinical training may qualify to take the CNA competency examination. Graduates of U.S. registered nursing (RN) or licensed practical nursing (LPN) programs within the preceding 24 months may qualify for direct CNA certification without taking the examination. RN or LPN graduates whose nursing education was completed more than 24 months earlier may qualify to take the competency examination without repeating CNA training. Certain foreign-trained nurses may also qualify to test after providing the required credentials. Individuals already certified as nursing assistants in another state may qualify for Delaware certification through reciprocity or an examination-based transfer pathway.

Training Hours & Clinicals

Delaware's current published CNA training requirements specify a minimum of 91 total hours of training, consisting of at least 75 hours of classroom instruction, including laboratory training, and 16 hours of supervised clinical skills training in a Department-approved Delaware licensed healthcare facility. Approved training programs may provide additional classroom, laboratory, or clinical hours beyond these minimum requirements.

This requirement reflects changes made to Delaware's CNA training framework in 2022. Previously, Delaware required 150 hours of training, equally divided between classroom and clinical instruction. The Delaware Department of Health and Social Services then set the minimum at 91 hours by an order in effect since February 19, 2022. You may still see the old 150-hour figure in older material, but the current minimum is 91 hours.

Before providing direct care to residents, students must complete the required introductory classroom instruction and demonstrate proficiency in the relevant nursing assistant skills. Under federal training regulations, at least 16 hours of introductory instruction must cover communication and interpersonal skills, infection control, safety and emergency procedures, promoting residents' independence, and respecting residents' rights before direct resident contact.

Delaware's approved CNA curriculum covers the nursing assistant's role and responsibilities, basic nursing skills, personal care, nutrition and hydration, infection prevention, communication, mental health and social-service needs, restorative services, care of individuals with cognitive impairments, and residents' rights. Students also learn to recognize and report changes in patients' conditions, document care appropriately, prevent abuse and neglect, and provide respectful care to older adults and individuals with disabilities.

Supervised clinical training allows students to apply these skills while caring for residents or patients in an approved healthcare setting. Clinical activities include assisting with bathing and dressing, feeding and hydration, transferring and positioning residents, toileting, mobility assistance, taking vital signs, and maintaining a safe care environment. Delaware requires students to demonstrate proficiency in each applicable skill before performing that skill on a resident or patient.

Under Delaware regulations, CNA training must be provided by or under the general supervision of a registered nurse with at least two years of RN experience, including at least one year providing nursing facility services. Classroom and clinical instructors must also meet applicable teaching qualifications. Licensed practical nurses with at least three years of LPN experience may assist with specified laboratory instruction and clinical training under RN supervision.

Delaware also requires additional facility-specific orientation for nursing assistants entering certain healthcare settings. The state's published CNA Registry guidance specifies at least 80 hours of orientation, including 40 clinical hours, for CNAs hired to work in covered facilities. These orientation hours are separate from the initial CNA training requirement and are intended to familiarize newly hired employees with facility procedures, equipment, resident care plans, safety requirements, and assigned duties.

Under federal regulations, Medicare- or Medicaid-certified nursing facilities may generally employ an individual as a nurse aide for up to four months while the individual completes the required training and competency evaluation, subject to applicable supervision and competency requirements. However, Delaware regulations require completion of an approved CNA training program and successful passage of the competency examination before an individual may work in a facility as a CNA. Delaware also establishes specific conditions for nursing assistants employed through facility-sponsored training programs, including a requirement to obtain certification within 90 calendar days after completing the training program.

Competency Exam (Knowledge & Skills)

After completing a DHCQ-approved training program, candidates must pass the Delaware Nurse Aide Competency Examination, administered by Prometric, the state's contracted examination and CNA Registry services provider. The examination consists of a written or oral knowledge examination and a practical clinical skills evaluation.

• Written knowledge examination: The written examination consists of 60 multiple-choice questions covering essential nursing assistant knowledge, including infection prevention, safety, residents' rights, communication, personal care, basic nursing skills, and recognizing changes in patients' conditions. Candidates have 90 minutes to complete the examination. An oral examination option is available for candidates who prefer to hear the questions read aloud while viewing and answering them on a computer. Your score report shows pass or fail as soon as you finish the test.
• Clinical skills evaluation: Candidates are evaluated on five nursing assistant skills. These consist of three assigned practical skills, together with handwashing and indirect care behaviors. Indirect care includes communication, residents' rights, safety, comfort, and infection prevention. The examination is timed, with the allowed time generally ranging from 31 to 40 minutes depending on the assigned skills. Candidates must demonstrate satisfactory performance on all five evaluated skills to pass.

The clinical skills examination assesses practical nursing assistant competencies such as assisting with mobility, personal hygiene, feeding, positioning, transfers, and measuring vital signs. Candidates must follow the applicable skills checklists and demonstrate required safety and infection-control procedures. Prometric provides official clinical skills checklists and examination instructions to help candidates prepare.

Under Delaware's certification regulations, candidates have up to three attempts to pass the required written and clinical skills examinations within 24 months of completing their approved training program. A training completion certificate older than 24 months is no longer valid for initial testing eligibility. Candidates who do not successfully pass the required examinations within the permitted attempts must repeat an approved CNA training program before testing again.

Candidates who fail only one examination component may retake that component without repeating the portion already passed, provided they remain within the applicable testing limits. Retesting requires payment of the appropriate examination fee.

Examination applications, scheduling, testing accommodations, and results are handled through Prometric. Candidates may test at approved facility-based or regional testing locations. Applicants should consult the current Delaware Candidate Information Bulletin for examination instructions, identification requirements, available testing locations, and applicable fees.

Placement on the Registry & Working as a CNA

After completing the required training and successfully passing both competency examination components, candidates become eligible for placement on the Delaware Nurse Aide Registry, maintained by the Delaware Division of Health Care Quality through its contracted registry provider, Prometric.

Applicants must submit the required examination application, provide documentation establishing eligibility for their chosen certification pathway, and pay the applicable examination fees. Candidates completing the standard training pathway must hold a valid certificate of completion from a DHCQ-approved CNA training program.

Once both examination components have been passed and the candidate's eligibility has been confirmed, the individual is added to the Delaware Nurse Aide Registry and receives CNA certification. Delaware CNA certification is initially valid for 24 months.

Employers can verify an individual's current certification through the state's online CNA Registry, managed by Prometric. The registry also provides information relevant to a nursing assistant's eligibility for employment, including certification status and applicable findings of abuse, neglect, mistreatment, or financial exploitation.

In Delaware, CNA certification is administered by DHCQ rather than the Delaware Board of Nursing. The Board of Nursing regulates licensed nurses, while certified nursing assistants perform nursing-related duties under the supervision of licensed nursing professionals.

Certified nursing assistants may assist patients with activities of daily living, personal hygiene, mobility, nutrition, and other basic care needs. CNAs must work within the responsibilities permitted for their role and may not independently perform duties requiring the professional judgment and skills of a licensed nurse.

Delaware certification is required before an individual may work in a position requiring state CNA certification. An active nursing assistant credential from another state does not automatically authorize employment as a CNA in Delaware without completing the appropriate certification or reciprocity process.

Certification Renewal

Delaware CNA certification must be renewed every two years. Certification is valid for 24 months from its issue date, and CNAs must complete the state's renewal requirements before their certification expires.

To qualify for renewal, Delaware CNAs must meet both of the following requirements during each 24-month certification period:

• Qualifying employment: Complete at least 64 hours of paid nursing or nursing-related services under the supervision of a nurse or physician during each 24-month certification period. Qualifying work must involve nursing-related duties performed for compensation. Volunteer work does not satisfy the paid-employment requirement.
• Continuing education: Complete at least 24 hours of DHCQ-approved continuing education during the preceding 24 months. These hours must include at least six hours of dementia training and two hours of training related to preventing resident or patient abuse, neglect, or mistreatment.

Delaware administers its CNA continuing education and renewal process through Relias. The state provides a designated continuing education package covering the required topics. CNAs must complete the applicable courses and document their qualifying employment through the online renewal process.

The Relias renewal package includes a self-reporting employment verification form, identified as z64, for documenting the required 64 hours of qualifying work. Applicants must provide information about their employer or facility, supervisor, employment dates, and other required identifying details. DHCQ also accepts Relias continuing education completed during your certification period and transferred from an employer's Relias account.

CNAs must complete their renewal requirements before their certification expires. Under Delaware regulations, renewal applications must be submitted at least 30 days before expiration. The standard renewal fee is $25, paid online through the Relias website.

CNAs who have completed all renewal requirements but miss their certification expiration date may qualify for late renewal within 30 days after expiration, subject to an additional $25 late fee. Individuals who do not renew within the permitted period are considered to have lapsed certification and may not work as CNAs until their certification is restored.

CNAs who fail to meet the required 64 hours of qualifying employment or 24 hours of continuing education must successfully retake the Delaware CNA competency examination to regain certification. The state requires lapsed CNAs to complete both the written and clinical skills examination components. Anyone who fails the exams three times must repeat an approved CNA training program before testing again.

Delaware does not permit CNAs who are already certified in the state to use an out-of-state certification to obtain reciprocity solely to avoid Delaware's continuing education requirements.

Reciprocity

Delaware offers CNA certification by reciprocity for nursing assistants who hold a current certification or registration in another U.S. state and meet Delaware's eligibility requirements. Approved applicants may be placed directly on the Delaware Nurse Aide Registry without repeating a Delaware-approved training program or taking the state's competency examination.

Under Delaware Administrative Code 3220, reciprocity applicants must hold a current nursing assistant credential in good standing from another jurisdiction and must have completed a nurse aide training program meeting at least the applicable federal training standards. Applicants from Maryland must hold a current Geriatric Nursing Assistant (GNA) certificate rather than relying on a Maryland CNA credential alone.

Delaware also requires applicants to satisfy one of two alternative qualification pathways:

• Employment-based eligibility: Documentation of at least three months of full-time nursing assistant employment, equivalent to 420 hours, during the preceding 24 months. Qualifying employment must involve paid nursing or nursing-related services performed under the supervision of a nurse or physician.
• Training-based eligibility: Documentation showing successful completion of an approved nurse aide training and competency evaluation program with a total number of training hours at least equal to Delaware's applicable state training requirement.

Applicants must submit the Delaware CNA Reciprocity Application with a copy of their current out-of-state certification, a government-issued photo ID, a notarized employer or training program verification form, a sealed National Practitioner Data Bank (NPDB) self-query report, which you order and pay for separately, and the reciprocity fee. DHCQ reviews the applicant's existing certification and supporting documentation before approving placement on the Delaware registry.

The reciprocity processing fee is $30, paid by check or money order made out to the State of Delaware. It is not refunded if the application is denied.

Individuals who hold an active CNA certification in another state but do not meet Delaware's requirements for direct reciprocity may still qualify to take the Delaware CNA competency examination without completing a new Delaware-approved training program. This examination-based pathway is separate from direct certification by reciprocity and requires the applicant to pass the applicable written and clinical skills examinations.

Approved reciprocity applicants generally do not need to repeat their full CNA training or retake the competency examinations. However, applicants must receive Delaware CNA certification and appear on the state's registry before working in a position requiring certification.

Costs & Reimbursement

The cost of CNA training in Delaware varies by approved training provider. Community colleges, vocational schools, nursing facilities, high schools, and private training institutions may charge different tuition and materials fees. Some employers offer facility-sponsored training or provide financial assistance for individuals planning to work at their facilities.

According to Prometric's published Delaware Candidate Information Bulletin, the listed competency examination fees are:

• Combined written knowledge and clinical skills examinations: $115
• Combined oral knowledge and clinical skills examinations: $115
• Clinical skills examination retake: $75
• Written or oral knowledge examination retake: $40

The Delaware Division of Health Care Quality lists the same $115 fee for the combined written and clinical skills examinations that a CNA must retake after a lapse.

Delaware's published CNA certification fees also include a $25 renewal fee, an additional $25 late renewal fee when applicable, and a $30 reciprocity processing fee. Training tuition, required materials, health screenings, and employer background checks may involve additional costs.

Under federal law, an individual who is employed by a Medicare- or Medicaid-certified nursing facility, or who has received an offer of employment from one, when beginning an approved nurse aide training and competency evaluation program may not be charged for the required training, textbooks, course materials, or competency evaluation.

If an individual pays for an approved nurse aide training and competency evaluation program and becomes employed by or receives an offer of employment from a Medicare- or Medicaid-certified nursing facility within 12 months after completing the program, eligible training and testing expenses must be reimbursed on the applicable prorated basis. These federal reimbursement requirements do not apply to every healthcare employer or training provider.

Delaware regulations provide additional details concerning reimbursement by qualifying nursing facilities. Eligible documented expenses include tuition, examination fees, textbooks, and other required course materials. Facilities must reimburse qualifying personally incurred costs in equal quarterly payments, with full reimbursement completed over the applicable one-year employment period. Nursing assistants should retain receipts and other proof of payment to support any reimbursement request.

Sources: Delaware Department of Health and Social Services – CNA Registry, Training Requirements, Certification Pathways, Renewal, and Reciprocity, Delaware Administrative Code 3220 – Training and Qualifications for Certified Nursing Assistants, Delaware DHSS Order on CNA Training and Qualifications (2022), Delaware DHCQ – CNA Reciprocity Application, Delaware DHCQ – Criminal Background Checks, Fingerprinting and Mandatory Drug Testing, Delaware Code Title 16, Chapter 30A – Certified Nursing Assistant Training and Certification Requirements, Delaware Division of Health Care Quality – CNA Certification, Renewal, and Reciprocity FAQs, Prometric – Delaware Nurse Aide Examination, Candidate Resources, and Registry Services, Prometric – Delaware Certified Nurse Aide Candidate Information Bulletin, Delaware DHCQ – Certified Nurse Aide Recertification Procedure, 42 CFR 483.152 – Federal Nurse Aide Training Requirements, 42 CFR 483.154 – Nurse Aide Competency Evaluation, 42 CFR 483.156 – Nurse Aide Registry Requirements