CNA Classes & Programs in Massachusetts

Before you begin training, it’s important to understand the requirements for becoming a Certified Nursing Assistant (CNA) in Massachusetts. Meeting these standards ensures you're eligible to test, be listed on the state registry, and work in approved healthcare settings.

Eligibility

• Program enrollment (NATCEP): You must complete a Massachusetts Department of Public Health (DPH)–approved Nurse Aide Training and Competency Evaluation Program. Programs are offered by community colleges, vocational schools, and long-term care facilities. Some applicants may qualify for a training waiver under 105 CMR 156.100 (e.g., certain nursing students) to take the competency exam without completing a full nurse aide course.
• Readiness & screenings: Schools and clinical sites commonly require health and immunization clearance and may require a CORI/background screening. Employers must verify Nurse Aide Registry status before hiring.

Training Hours & Clinicals

Massachusetts requires a minimum of 75 total hours in a DPH-approved curriculum, including classroom/lab instruction and supervised practical training. Federal rules also require at least 16 hours of instruction—covering topics such as communication, residents' rights, safety and emergency procedures (including the Heimlich maneuver), and infection control—before any direct resident contact. Additionally, programs must include at least 16 hours of supervised clinical training in a licensed healthcare facility. Many Massachusetts programs exceed these minimum standards.

Certification Exam

After completing training (or qualifying for a waiver), you must pass both parts of the DPH-approved competency exam, administered by D&SDT-HEADMASTER:

• Knowledge test (written or oral): 60 multiple-choice questions in 60 minutes; a passing score of 76% or higher is required. The exam is also available in Spanish, Chinese (traditional and simplified), and Haitian Creole.
• Skill test: a timed evaluation (up to 40 minutes) of three or four randomly selected skills. You must demonstrate one mandatory task with embedded handwashing (such as assisting a resident with a bedpan or providing perineal care), plus two or three additional randomly selected tasks from a pool of nurse aide skills.

You must correctly perform all critical steps (bolded in the candidate handbook) and at least 80% of non-critical steps for each assigned skill to pass. Candidates have up to four attempts to pass the knowledge test and three attempts to pass the skill test before retraining is required.

Placement on the Registry & Working as a CNA

After passing both exam components, your name is added to the Massachusetts Nurse Aide Registry. Results are typically posted within three weeks. Employers must verify your registry status before hiring. Under federal rules, a facility may employ a trainee for up to 120 days while training and testing are being completed.

Renewal

Massachusetts CNA certification must be renewed every 24 months. To renew, you must have performed at least 8 consecutive hours of paid nursing or nursing-related duties under appropriate supervision during the preceding 24 months.

Costs & Reimbursement

Current exam fees (set by D&SDT-HEADMASTER) are $30 for the knowledge test ($40 for the audio version) and $70 for the skill test. Under federal law, if you are employed by—or receive an offer from—a Medicare/Medicaid-certified nursing facility when you begin training, the facility must cover your training and testing costs. If you are hired within 12 months of completing training, the facility must reimburse those costs on a prorated basis.

Reciprocity

If you are already certified in another U.S. state and in active, good standing, and have never been certified in Massachusetts, you may apply for out-of-state reciprocity to be placed on the Massachusetts Nurse Aide Registry without retraining. Applicants must submit verification of current certification and meet all DPH review requirements.

Sources: Massachusetts DPH – Learn How to Become a CNA, Massachusetts DPH – Nurse Aide Registry Program, Massachusetts Nurse Aide Candidate Handbook (HEADMASTER, Jan 2025), 105 CMR 156.300 – Minimum Curriculum Standards, 42 CFR 483.152 – Federal Training Requirements