CNA Training Curriculum: Federal Requirements, State Additions, and Clinical Competencies

CNA curricula must meet federal OBRA minimums; states add hours and content. Programs combine theory, lab, and supervised clinical practice.

Federal OBRA Required Content (42 CFR 483.152)

• Communication & interpersonal skills
• Infection control (standard precautions, hand hygiene, PPE, isolation)
• Safety/emergency (fire, disaster, choking, fall prevention)
• Resident rights & independence
• Basic nursing skills (vitals, hygiene, nutrition, elimination, mobility)
• Personal care skills (ADLs)
• Mental health & social service needs
• Care of cognitively impaired residents
• Basic restorative services
• Resident abuse/neglect identification & reporting

Common State/Add-On Topics

• Anatomy/physiology overview
• Medical terminology
• Nutrition/hydration detail
• CPR/BLS certification (often separate)
• End-of-life care / hospice basics
• Cultural competency
• Documentation/EHR practice
• Medication awareness (assist with self-administration only in some states)
• Alzheimer's/dementia specific (CA, FL, others mandate)

Clinical Competency Skills (Testable)

• Hand hygiene, PPE donning/doffing
• Vital signs (all routes)
• Bedmaking (occupied/unoccupied)
• Bed bath / perineal care
• Transfer (bed↔chair, mechanical lift)
• Ambulation with gait belt
• Feeding (oral, thickened liquids)
• Catheter care (indwelling, condom)
• Brief application / incontinence care
• Range of motion (active/passive)
• Postmortem care

Program Length & Certification

• Total hours: 75–180 (state-dependent).
• Clinical minimum: 16 hrs (federal); states often 24–40+.
• State competency exam: Written (60–70 questions) + Skills (5 random from 20–30).
• Registry placement upon pass.