CNA and LNA Classes & Programs in New Hampshire

Before starting your training, it's important to understand exactly what New Hampshire requires to become a Certified Nursing Assistant (CNA). In New Hampshire, nursing assistants are officially known as Licensed Nursing Assistants (LNAs) and must obtain a state license through the New Hampshire Office of Professional Licensure and Certification (OPLC), under the authority of the New Hampshire Board of Nursing. Meeting these requirements allows you to complete the required training and competency examinations, receive your LNA license, 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 New Hampshire Board of Nursing-approved nursing assistant education program. Approved programs are offered through community colleges, healthcare facilities, vocational training providers, and other authorized educational institutions.
• Age and admission requirements: New Hampshire's Nurse Practice Act does not establish a universal minimum age for initial LNA licensure. Individual nursing assistant training programs may impose their own age, educational, or health requirements. Applicants must demonstrate sufficient English-language proficiency to read, understand, write, and communicate effectively in relation to nursing assistant duties.
• Fingerprinting and background check: Applicants for initial licensure must submit a criminal history record release authorization and a complete set of fingerprints for background checks through the New Hampshire State Police and Federal Bureau of Investigation (FBI). Applicants must also disclose relevant criminal charges, convictions, and disciplinary matters. Certain criminal histories may affect eligibility for licensure and require additional review.
• Alternative pathways: Nursing students who have successfully completed the Fundamentals of Nursing curriculum, or equivalent coursework, in a Board-approved nursing education program may qualify to take the LNA competency examination without completing a separate nursing assistant training program. A separate alternate experience route is open to military medics who have used those skills in the last 3 years (such as Army 68W, Air Force 4N0X1, Navy hospital corpsmen and Coast Guard health services technicians), and to licensed EMTs, advanced EMTs and paramedics who hold current National Registry (NREMT) certification. Individuals already licensed or certified as nursing assistants in another state may qualify for licensure by endorsement.

Training Hours & Clinicals

New Hampshire's published nursing assistant training standards specify at least 100 total hours of instruction, consisting of 40 hours of theoretical instruction and 60 hours of concurrent supervised clinical experience. Training must be provided through a Board-approved nursing assistant education program.

Before providing direct care to patients or residents, students must complete at least 16 hours of introductory instruction. Required subjects include orientation to the nursing assistant role, communication skills, safety and emergency procedures, a holistic approach to care throughout the lifespan, and protecting patients' rights, dignity, and confidentiality.

The curriculum covers basic nursing skills, personal hygiene, nutrition, mobility and transfers, infection prevention, restorative services, emotional and social needs, care of individuals with cognitive impairments, and emergency procedures. Students also learn to observe and report changes in patients' conditions, provide respectful personal care, and assist individuals in maintaining independence.

The supervised clinical component allows students to apply these skills while caring for patients or residents under appropriate nursing supervision. Clinical experiences include assisting with bathing and dressing, feeding and hydration, positioning and transferring, toileting, mobility, and maintaining a safe care environment.

Under the state's published nursing assistant education standards, training programs must evaluate students' knowledge and practical skills. Students are expected to achieve a grade of at least 70% on examinations covering theoretical content and receive a passing grade on practical skills evaluations. These program-level assessments are separate from the competency examination required for state licensure.

Federal rules let a Medicare- or Medicaid-certified nursing home use a nurse aide for up to four months while they finish training and testing. New Hampshire law is stricter: you need an LNA license before you can work as a nursing assistant. Students give hands-on care as part of their approved program's clinical training. After you pass the exam, you can get a temporary LNA license while your fingerprint background check is processed, as long as you passed a background check through your training program in the past 12 months. With a temporary license, you work under the supervision of a New Hampshire registered nurse.

Competency Exam (Knowledge & Skills)

After completing an approved nursing assistant training program, eligible candidates must pass a New Hampshire Board of Nursing-approved nursing assistant competency examination. The examination consists of a written or oral knowledge evaluation and a practical clinical skills evaluation.

The Board of Nursing approves the organizations that give the exam. OPLC lists Excel Testing in Manchester as the approved competency testing agency and Lakes Region Community College in Laconia as an approved competency testing service.

• Written or oral knowledge examination: Candidates must demonstrate their understanding of essential nursing assistant knowledge, including basic nursing care, communication, safety, infection prevention, patient rights, personal care, nutrition, mobility, and observation and reporting. On the Excel Testing exam, the written test has 60 multiple-choice questions, you get 90 minutes, and you need a score of 70% or higher to pass. If you ask in advance, you can take it as an oral exam, with the questions read aloud.
• Clinical skills evaluation: Candidates must demonstrate assigned nursing assistant skills under the observation of an authorized evaluator. Evaluated skills may involve personal care, mobility and transfers, vital signs, infection control, communication, and other nursing-related activities. On the Excel Testing exam, you perform four skills chosen at random, with 30 minutes to finish. Missing a step marked as critical fails the skills test, and so do 4 or more other errors.

Candidates must successfully complete both the knowledge examination and the clinical skills evaluation to qualify for licensure. If you fail one part, you retake only that part. Excel Testing requires at least 2 days between attempts and charges a fee to retest.

Examination registration, scheduling, testing accommodations, and fees are handled through the applicable testing service. Candidates should confirm the current examination procedures and any retesting requirements before scheduling their examinations.

Placement on the Registry & Working as a CNA

After completing the required training, passing the competency examinations, and meeting the applicable application requirements, candidates receive a New Hampshire Licensed Nursing Assistant (LNA) license through the Office of Professional Licensure and Certification, under the authority of the New Hampshire Board of Nursing.

Applicants must submit the required initial licensure application and nursing assistant addendum, provide evidence of successful training and competency examination completion, complete the required criminal background-check process, and pay the applicable licensing fee. Training programs may report completion and examination information directly to OPLC, reducing the need for applicants to submit duplicate documentation.

New Hampshire maintains a nursing assistant registry in accordance with state and federal requirements. Once licensed, nursing assistants can be verified through the state's professional licensing verification system. Employers can use the system to confirm that an individual holds an active New Hampshire LNA license.

Licensed Nursing Assistants perform nursing-related duties under the supervision of a registered nurse (RN), advanced practice registered nurse (APRN), or licensed practical nurse (LPN). Their duties may include assisting patients with activities of daily living, personal hygiene, mobility, nutrition, and other basic care needs.

New Hampshire also offers a Medication Nursing Assistant (MNA) certificate. To earn it, an LNA who has worked as an LNA for one full year completes a Board-approved medication administration program and passes an exam. Without the certificate, an LNA gives medication only when a nurse delegates the task in home care, hospice, residential care, public school or adult day care settings.

Individuals holding CNA certification or nursing assistant licensure in another state must obtain the appropriate New Hampshire authorization before working in a position requiring an LNA license. An out-of-state credential does not automatically provide an unrestricted right to practice as an LNA in New Hampshire.

Certification Renewal

New Hampshire LNA licenses must be renewed every two years. Each license is valid for two years from the date it was issued. Renewal applications must be submitted through the New Hampshire Office of Professional Licensure and Certification, together with the required fee and evidence of continued eligibility.

Under New Hampshire Revised Statutes RSA 326-B:31 and the Board of Nursing's rules, LNAs must complete at least 12 contact hours of continuing education each year, equivalent to 24 hours over a two-year renewal period. Continuing education must enhance nursing assistant knowledge, judgment, and skills and may include qualifying workshops, conferences, lectures, or in-service educational programs. Successful completion of a state nursing assistant competency examination may also be used to satisfy the continuing education requirement.

OPLC also lists an active practice requirement for renewal: at least 200 hours of nursing assistant work under a licensed nurse's supervision in the two years before you apply, or a passing result on the nursing assistant competency test in that time.

LNAs who also hold a medication administration certificate must complete at least four hours of their annual continuing education in medication administration, as required by the state's Nurse Practice Act.

Renewal applicants must accurately report their continuing education and any relevant criminal or disciplinary matters. The Board may request supporting documentation when reviewing an application or auditing compliance.

You cannot work on an expired license, and an expired license cannot be renewed online. If it expired less than one year ago, you reinstate it by mailing OPLC's paper reinstatement application with the fee. Once it has been expired for one year or more, you apply again as a new applicant, including a new criminal background check.

Reciprocity

New Hampshire offers licensure by endorsement for nursing assistants who hold a current, unencumbered certification or license in another U.S. state and meet New Hampshire's eligibility requirements. Applicants must submit the appropriate licensure application through the Office of Professional Licensure and Certification and provide verification of their existing nursing assistant credential.

Under New Hampshire's license reciprocity law, OPLC's endorsement application asks for:

• Existing certification or licensure: An active nursing assistant license, certification or registration in good standing from another U.S. state, earned by completing a state-approved nurse aide training program and passing a state-approved nursing assistant exam.
• Verification: Proof from the other state's registry or licensing board that your credential is active and in good standing, uploaded with your online application.
• Background check: Completion of the required criminal history record authorization and fingerprint-based background checks through the New Hampshire State Police and FBI.

If everything else in your application is in order but your background check results are not back yet, OPLC issues a provisional license that lets you work in New Hampshire while you wait.

Approved endorsement applicants generally do not need to repeat New Hampshire's full 100-hour nursing assistant training program or complete a new competency examination when their existing qualifications satisfy the applicable endorsement requirements. However, applicants must receive New Hampshire LNA licensure before practicing in a position that requires it.

New Hampshire is a member of the Nurse Licensure Compact for registered and practical nurses, but LNA licenses are not covered by the Nurse Licensure Compact. Nursing assistants transferring from another state must therefore follow the applicable New Hampshire endorsement process.

Costs & Reimbursement

The cost of nursing assistant training in New Hampshire varies by approved training provider. Community colleges, healthcare facilities, vocational schools, and private educational institutions may charge different tuition, examination, and materials fees. Some healthcare employers offer sponsored training or financial assistance for individuals planning to work in their facilities.

Under New Hampshire's published licensing fee regulations, the standard LNA initial licensing, renewal, and reinstatement fee is $38. In addition, the Office of Professional Licensure and Certification assesses a mandatory $28 Professionals' Health Program fee for nursing licenses. Together, these charges amount to $66 for an LNA licensing application or renewal, excluding other applicable expenses.

Applicants must also pay the required fingerprinting and criminal background-check costs. Competency examination fees are charged separately by the approved testing provider. For example, Excel Testing publishes a combined fee of $200 for its written and clinical skills examinations. Candidates should confirm current examination fees and payment requirements directly with their chosen testing service.

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 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, federal law requires the state to provide for reimbursement of your training and testing costs. These federal rules apply to certified nursing facilities, not to every healthcare employer or training provider.

In New Hampshire, the Department of Health and Human Services pays this reimbursement under administrative rule He-E 804. If you start work, or get a job offer, as an LNA at a licensed nursing facility within 12 months of finishing your training and passing the exam, you can apply on the department's form with your receipts and your certificate. You give the application to the facility's administrator, who sends it to the department. The department pays back what was actually paid for training and testing in one payment, not including items such as uniforms or the background check.

Sources: New Hampshire General Court – Nurse Practice Act (RSA 326-B), RSA 326-B:19 – Licensed Nursing Assistant Licensure by Examination, RSA 326-B:15 – Criminal History Record Checks, RSA 326-B:22 – License Renewal, RSA 326-B:31 – Continuing Education, RSA 326-B:21-a – Licensure by Alternate Experience, RSA 326-B:24 – Temporary Licenses, RSA 310:8 – License Renewals and Expiration, RSA 310:17 – License Reciprocity, Office of Professional Licensure and Certification – Licensure by Endorsement (Plc 313), New Hampshire Board of Nursing – Administrative Rules (including Nur 704.09 Curriculum, Nur 403.02 LNA Continuing Education, and Nur 302.05 Endorsement), New Hampshire Office of Professional Licensure and Certification – Licensing Fees (Plc 1001.08 and Plc 1002.33), Excel Testing – New Hampshire Nursing Assistant Competency Examinations, Excel Testing – Examination Registration and Fees, Excel Testing – Nurse Aide Competency Test Guide, New Hampshire Department of Health and Human Services – LNA Training and Competency Testing Reimbursement (He-E 804), 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