Changes to Nursing Home Certified Nurse Aide (CNA) Competency Exam Program

October 7, 2011

DAL: DRS-NH 11-10 - Changes to Nursing Home Certified Nurse Aide (CNA) Competency Exam Program

Dear Administrator:

Over the past year, the Department of Health has worked in collaboration with Prometric and key stakeholders to identify and implement improvements to the New York State Nurse Aide (CNA) Competency Evaluation. These changes, which focus primarily on exam content and administration, will promote greater standardization, fairness and efficiencies in the program and were effective October 1, 2011. The changes to the exam and examination administration are:

1. The written/oral exam time limit is changed from 120 minutes to 90 minutes in accordance with industry standards.

Time studies show that over 94% of NY candidates complete the written/oral exam in 90 minutes. (90% complete it in less than 60 minutes.) Of the remaining 6% who complete the exam in more than 90 minutes, 40% fail. Thus capping the time allowed to complete the exam at 90 minutes is anticipated to have little impact on pass rates. Candidates who have special needs and require extra time can still request additional time through an Americans with Disabilities Act (ADA) accommodation.

2.The clinical skills exam content has been modified in accordance with Prometric's 2010 National Nurse Aide Job Analysis.

Based on the recommendation of Prometric's National Examination Council, the list of skills included on the clinical skills exam, and the specific skills demonstration scenarios, have been modified. Updated clinical skills checklists, developed to evaluate candidates' performances based on the scenarios in the instructions, will be posted online. Please note that there has been no change to the State's training curriculum. Skills that have been removed from the clinical skills exam must still be taught to candidates in classroom and clinical settings.

3. Setting a time limit for the new clinical skills exam.

Candidates no longer have unlimited time to complete the clinical skills exam. By establishing time limits, we are promoting fairness and standardization for all candidates. Each test form is assigned a time limit that is determined by the specific combination of skills on the form. Candidates will be informed of the time limit for their exam when they are given the instruction card at the beginning of testing. Total time allowed for each combination of skills ranges from 31 to 40 minutes.

4. Establishing a minimum number of candidates for an in-facility test event (IFT).

In an effort to improve operational efficiency and avoid exam fee increases, Prometric will no longer schedule IFT requests for events with three or fewer candidates. Nurse aide training programs (NATPs) may work together to combine candidates from multiple programs into a single event at one IFT facility. If an IFT event cannot be scheduled because the minimum number of candidates cannot be met, the candidates can be scheduled at a nearby regional test site at which it is more likely that the minimum test event size can be achieved. Prometric will take responsibility for ensuring that the minimum test event size of four candidates is achieved at regional test sites.

5. Providing internet access to detailed diagnostic information on clinical skills exam results.

Candidates who are interested in early notification of their clinical skills exam results will now be able to view their scores online, typically within 48 hours after completing the exam. Candidates – both passing and failing – can also review the specific checkpoints they missed on the exam in order to prepare for retesting or to provide better care to residents in the future.

In addition, beginning October 1, 2011, Prometric will limit the number of candidate handbooks sent to training programs. This is being done not only to contain costs but also because the handbook will be modified next year and copies mailed out in 2011 will be out of date. The training program manual is available online only. Both the handbook and the manual can be downloaded from

Detailed information about these upcoming changes is available at the same internet address as well as general instructions for candidates, clinical skills checklists and more. Questions regarding these changes can be directed to the Bureau of Credentialing at (518) 408-1297 or by email to


Richard Cook
Deputy Commissioner
Office of Health Systems Management