CNA Exam and Certification Massachusetts

The state of Massachusetts needs qualified and trained nursing assistant professionals. However, before you begin working in a nursing home, you must be listed on the Nurse Aide Registry. Employers must verify that a potential employee is listed in good standing on the state Registry before delegating nursing assistant duties in a nursing home. After successfully completing an approve nurse aide training program and passing the state-approved test, your name will be added to the Registry, and you’ll receive a certificate and wallet card to validate your status. The American Red Cross, working in collaboration with the Massachusetts Health Care System, administers the state CNA exam in a standardized quality testing environment.

CNA Classes in MA:

How to Apply for the Massachusetts CNA Exam

If you wish to become certified after completing a state approved nursing assistant training program, you are eligible to submit an application for the state certifying exam.

Previously certified nursing assistants in Massachusetts are also eligible to retest to reinstate a, expired certification. If you fall into this category, contact the ARC to determine your eligibility to retest.

Your employment and training experience may be substituted for nursing assistant training as listed below:

Board Approved Nursing Assistant Training

Submit your Certificate of Completion with your application. The Certificate must include a valid approval number. Alternatively, you may submit a letter from the training program indicating that you passed the course. The letter should be printed on an official letterhead and include a valid approval number, your name, and date you completed the course. Candidates are eligible to test indefinitely as the training does not expire.

Nursing School Clinical Training

After completing at least 75 hours of accredited clinical training in an approved nursing school, you may use your learning to apply for the state CNA exam. Submit a signed letter from the nursing school validating your completion of 75 hours of clinical training. The letter should also indicate your name, course names, and dates. Alternatively, you may submit an official transcript with the course title and course description – if the title does not expressly state clinical training.

Nursing Home Work Experience

If you worked at a Massachusetts Nursing Home as of December 19, 1989 and continued working at the same home as a nurse aide for at least two years, you are eligible to take the exam without further training. Submit a letter from the nursing home outlining your employment for at least 24 consecutive months.

Nurse Aide Training Program Before July 1, 1989

If you completed a 100-hour nurse aide training course before July 1, 1989, you are eligible to take the test without further training. Submit a completed Testing Eligibility Application to the MDPH before submitting an application for the exam. If the MDPH approves your request, return the Testing Eligibility Application, provided by the MDPH, to the ARC with your application for the exam.

Health Care Aide Training and Work Experience

Your training and work experience as a health care aide qualify you to take the exam if you completed the training in the past five years and worked for more than two years as a health care aide. The MDPH will review applications individually and will grant approval based on the similarity of the training to the nurse aide training.

If you fall in one of the categories listed above, you will be eligible to take the test.

  • Submit a completed Massachusetts Nurse Aide Testing and Registration Application Form – available at the ARC or your training provider.
  • Attach your documentation of eligibility. Without it your application will not be processed.
  • Attach a money order or cashier’s check made payable to American Red Cross. Pricing available below.

Make sure you enter your social security number, mailing address, phone contact, training program information, and sign the application.

If you have a disability, the ARC will make reasonable arrangements to accommodate you on the day of the exam. You must request accommodations with your application and include a letter from a licensed health professional indicating the nature of your disability and a separate letter describing the special arrangements needed.

Allow at least 26 days after submitting a completed application to be scheduled to take the test. The ARC will send written notification of your test date within 7 to 10 days before the scheduled date.

If you need to reschedule after you missed a test date, you must send a letter stating that you’d like to be rescheduled. The letter should contain your name, address, SSN, where you were scheduled to take the test and date, the location where you’d like to test, and any dates you’re not available. The ARC will keep your application on file for one year from the originally scheduled test date. If you apply to reschedule after a year, you’ll have to reapply and pay the full fee.

The fees rescheduling are as follows:

  • Knowledge and clinical skills test – $40
  • Knowledge test (written or oral) – $20
  • Clinical skills test – $20

Submit a request in writing if you’d like to have your testing fees refunded. Refunds are available for up to one year from the original test date. A processing and scheduling fee will be deducted.

Exam Costs

The established testing fees in Massachusetts are as follows:

  • Knowledge (written) and clinical skills tests – $93.00
  • Knowledge (oral) and clinical skills tests – $103.00

CNA Exam Overview Massachusetts

The Nurse Aide Competency Evaluation is composed of two parts: the Knowledge test and the Clinical Skills test. First-time candidates will take both tests on the same day. However, both tests are independent of one another, so it is possible to pass one while failing the other. You’ll only have to retake the test you fail. The state allows nurse aide candidates four chances to pass the knowledge test and three chances to pass the clinical skills test. If you do not pass the test in the allowed attempts, you must retrain before you reapply to take the exam. You must pass both tests to be listed on the Massachusetts Nurse Aide Registry.

The Written Exam

The Knowledge test, comprising of 60 multiple-choice questions, is administered in a group setting. You’ll have a maximum time of two hours to complete the test. The test covers all the areas you’ll need to know to perform competently on the job. A sample test is outlined in the Candidate Handbook that you should request from the American Red Cross.

The content outline and percentage assigned to each category are as follows:

Injury prevention, safety and emergency (15%) – includes falls, seizures, fire protection and burns, body mechanics, oxygen use, and identifying potential hazards.

Prevention and control of infection (15%) – includes standard precautions, cleaning and sterilizations, symptoms of common infections, isolation procedures, microorganisms and their related infections.

Resident’s rights (13%) – includes the right to information, right to exercise one’s rights, grievance rights, protection of personal funds,  and right to choose.

Basic nursing skills (13%) – includes routine responsibilities and procedures and acute and chronic illnesses, such as cancer, AIDS, diabetes, etc.

Personal care skills (12%) – including grooming, bathing, skin care, assisting with elimination, fluids, nutrition, dressing and undressing, and oral hygiene.

Communication skills ((10%) – includes call lights, communicating with depressed residents, basic human needs, responding to demanding residents, and confidentiality.

Restorative care (8%) – includes self-care, the aging process, range of motion, bowel and bladder training.

Responding to atypical resident behaviors (7%) – includes anger, hallucinations, wandering, confusion, depressing, and combativeness.

The role of the nurse aide (7%) – includes personal health and safety, working with family, members of the health care team, and ethics, values, and legal issues.

The Oral Exam (Alternative)

The Knowledge test is available in oral format. To take the Oral version on the test, you must request it on the application, pay the corresponding fee, and take the exam at an ARC Regional test site. At the test site, a test observer will provide a CD player so you can hear the questions and record your answers in the answer booklet. The Oral test follows the same content outline as the Written test.

The Skills Exam

The clinical skills test is administered individually for the test observer to evaluate your ability in a personal setting. The nurse aide training program will prepare you for success on the exam. Review the skills in your textbook – they should cover all the skills listed in the Candidate Handbook. Listen to the instructions of the charge nurse carefully and ask questions before the test begins. The test observe will rate your documentation skills, indirect care skills, handwashing and use of gloves, and ability to follow instructions. Apart from those skills, you’ll be tested on your performance of two additional skills selected at random from the skills list.

What To Bring To The Exam

It is essential that you arrive fifteen minutes before the scheduled time for both the knowledge (or oral) and clinical skills test. If you arrive late while the test is already in session, you will not be allowed to take the exam and you must reapply and pay another fee to reschedule.

Take two forms of identification: one with a current and clear photo. Both must match the information used to register for the exam. Acceptable forms of ID are a state-issued driver’s license, military ID, permanent resident card, or a current passport.

For the clinical skills test, you must bring an actor at least 18 years old. The actor must be someone who will not take the test within the next 6 months. The individual should bring a toothbrush and a comb. You do not need to wear a uniform for the clinical test, but you must bring a watch with a second hand to the test site.

Receiving Your Scores

As of July 1, 2011, preliminary test scores will not be given on the same day of the test. If you pass both tests, you’ll receive your certificate in the mail within three weeks of taking the exam. If you fail the exam, your notification letter, sent within three weeks, will contain information on reapplying for the test(s) you failed. Results will not be given over the phone.

Contact the Registry

Massachusetts Nurse Aide Registry
Division of Health Care Quality
Department of Public Health
99 Chauncy Street, 2nd FL
Boston, MA 02111
(617) 753-8143

Massachusetts CNA Testing
The American Red Cross Testing Office:
American Red Cross Testing Office
85 Lowell St.
Peabody, MA 01960
Toll-Free Number: 1-800-962-4337
Local Number: 781-979-4010
Fax Number: 781-979-4014
Email Address: