CNA Classes & Programs in Nebraska

Before starting your training, it's important to understand exactly what Nebraska requires to become a Certified Nursing Assistant (CNA), referred to by the state as a nurse aide. Meeting these requirements ensures you're eligible to complete the state competency examinations, be placed on the Nebraska Nurse Aide Registry, and work as a nurse aide in Nebraska nursing homes.

Eligibility

• Age requirement: You must be at least 16 years old to qualify as a nurse aide in Nebraska.
• Program enrollment: The standard pathway requires successful completion of a State of Nebraska-approved nurse aide training course and the state-approved competency examinations.
• Language requirement: You must be able to speak and understand English or a language understood by a substantial portion of the residents of the nursing home where you work.
• Criminal history: You must not have been convicted of a crime involving moral turpitude that is rationally related to the position of a nurse aide. A substantiated finding of abuse, neglect, or misappropriation may also make a nurse aide ineligible to work in a certified nursing home.
• Alternative pathways: Certain nursing students, foreign-trained nurses, and individuals with inactive or lapsed RN or LPN licenses may qualify for placement on the Nurse Aide Registry based on their previous education or credentials. Depending on the pathway and how recently the individual practiced or completed qualifying education, Nebraska may also require the state-approved written/oral and skills examinations.

Training Hours & Clinicals

Nebraska's state-approved nurse aide course must include at least 75 clock hours of instruction, including at least 16 hours of supervised practical training. Nebraska also requires nurse aides to successfully complete an additional one hour of Nebraska-specific instruction on reporting suspected abuse, neglect, and misappropriation.

Before having any direct contact with residents, trainees must complete at least 16 hours of training covering communication and interpersonal skills, infection control, safety and emergency procedures including emergency measures for choking, promoting residents' independence, and respecting residents' rights.

The remainder of the required curriculum covers basic nursing skills, personal care skills, mental health and social-service needs, care of cognitively impaired residents, basic restorative services, and residents' rights. During practical training, students must be supervised and may perform only services for which they have been trained and found proficient.

Under federal rules, a Medicare- or Medicaid-certified nursing facility may employ an individual as a nurse aide for no more than four months unless the individual has completed an approved training and competency evaluation program or otherwise meets the applicable competency requirements.

Competency Exam (Written/Oral & Skills)

After completing the required training or qualifying through an approved alternative pathway, candidates must pass a State of Nebraska-approved written or oral examination and a clinical skills competency examination.

• Written/oral examination: The knowledge examination consists of 50 multiple-choice questions. Candidates must score at least 70% to pass. Candidates may take an approved written or oral version of the examination.
• Clinical skills examination: Candidates must demonstrate six nurse aide skills. A score of at least 70% on each skill is required, and any mandatory steps included in a skill must be performed correctly. Failing any one of the six skills results in failure of the skills examination.

Candidates have a total of three opportunities to pass each examination. If a candidate does not pass the written/oral examination or the skills examination after three attempts, the candidate must complete the 75-hour nurse aide training course again before retesting.

Placement on the Registry & Working as a CNA

After meeting Nebraska's training and competency requirements, eligible nurse aides are placed on the Nebraska Nurse Aide Registry, maintained by the Nebraska Department of Health and Human Services (DHHS). Nebraska does not issue a separate physical nurse aide license or certification card. Registry status can be verified online, and nurse aides can generate and print a wallet card through the state's registry system.

Registry records are classified as active, lapsed, or ineligible. An active status indicates that the nurse aide has passed the required examinations and/or has qualifying nurse aide employment within the previous two years. An ineligible status may result from a qualifying conviction or a finding of abuse, neglect, or misappropriation and prevents the individual from working as a nurse aide in a certified nursing home.

Maintaining Active Registry Status

Nebraska does not list a regular expiration date for an active nurse aide registration. Instead, to remain active on the Nurse Aide Registry, you must have worked as a nurse aide in a paid position within 24 months of your last qualifying nurse aide employment. Unlike many states, Nebraska does not specify an eight-hour minimum for maintaining active registry status.

The work must be performed in an employer setting recognized by Nebraska DHHS. Approved settings include nursing facilities, skilled nursing facilities, hospitals, critical access hospitals, assisted-living facilities, licensed home health agencies, hospices, health clinics, ambulatory surgical centers, intermediate care facilities, psychiatric or mental hospitals, rehabilitation hospitals, and certain certified community-based developmental disabilities service providers.

If there is no record of qualifying employment or successful competency examinations during the previous two years, your registry status becomes lapsed. A lapsed nurse aide can generally reactivate by successfully retaking both the state-approved written/oral and clinical skills examinations. A nurse aide who originally completed a 30-hour course before 1989 and was grandfathered onto the Registry cannot reactivate through testing alone and must complete the current 75-hour nurse aide course.

Interstate Endorsement

A nurse aide who is active in another state may apply for placement on the Nebraska Nurse Aide Registry through interstate endorsement. To qualify, the applicant must be active in the state from which endorsement is requested, have completed at least a 75-hour nurse aide training program, and have passed written and clinical competency examinations. If the applicant has not tested within the previous 24 months, Nebraska also requires qualifying nurse aide employment during that period.

All nurse aides transferring to Nebraska must complete at least one hour of Nebraska-specific abuse, neglect, and misappropriation training, even if they completed similar training in another state. Nebraska DHHS verifies registry status with the state where the applicant received training and other states where the applicant has worked as a nurse aide. A nurse aide must become active on the Nebraska Registry before working in a Nebraska certified nursing facility. DHHS advises that processing a completed interstate endorsement application may take up to 30 days.

If you were previously active on the Nebraska Nurse Aide Registry, you cannot use the interstate endorsement process to return to active status. Instead, you must meet Nebraska's reactivation requirements through competency testing or qualifying employment verification.

Costs & Reimbursement

Nebraska does not charge an application or registry fee for nurse aides, and Nebraska nurse aides do not pay a fee for certification or verification of their registry status. Training and competency-examination costs vary by the approved training and testing provider.

Under federal requirements, an individual who is employed by—or has received an offer of employment from—a Medicare- or Medicaid-certified nursing facility when beginning an approved nurse aide training and competency evaluation program may not be charged for any portion of 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, the facility is responsible for reimbursing eligible training and competency-evaluation costs on the applicable prorated basis.

Sources: Nebraska Department of Health and Human Services – Nurse Aide, Nebraska DHHS – Nurse Aide Requirements, Nebraska DHHS – Title 172 Professional and Occupational Licensure, Nebraska Administrative Code Title 172, Chapter 108 – Approval of Training Programs and Qualifications for Nurse Aides in Nursing Homes, Nebraska DHHS – Approved Employer Settings for Nurse Aides, Nebraska DHHS – Nurse Aide Interstate Endorsement Application, Nebraska DHHS – Nursing Facility Provider Handbook, Nebraska Medicaid – Nurse Aide Training and Competency Evaluation Reimbursement Guidance, 42 CFR 483.152 – Federal Nurse Aide Training and Reimbursement Requirements