Nursing Assistant in Washington State: Certification & Registry Rules

In Washington, the path to becoming a certified nursing assistant (CNA) is specially designed so that you may begin working as a CNA even as you are still completing your education. The state of Washington recognizes the difference between a Nursing Assistant Registered (NAR) and a Nursing Assistant Certified (NAC) individual. The following is a guide to the regulations you need to follow to go from initial registration to full certification and beyond.

Initial Eligibility and the “NAR” Gateway

To begin your career as a nursing assistant in Washington state, you must meet the entry-level requirements. While the state does not require applicants to have a high school diploma, they have stringent safety and age requirements.

Age: Applicants must be at least 17 or 18 years old depending upon the healthcare facility.

Identification: Applicants must have a valid Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN).

Health Screening: A proof of a negative Tuberculosis (TB) test taken in the last 12 months, along with up-to-date immunizations, including MMR, Td, and Hepatitis B is required.

Criminal Background: Applicants must pass the background check through the Washington State Patrol.

The most distinctive aspect of the Washington system is the two-tier system of credentialing for the Nursing Assistant Registered (NAR) and the Nursing Assistant Certified (NAC).

The NAR Gateway: An NAR is an entry-level “training license” that enables an individual to immediately enter the workforce, even if they have yet to begin their education. To become an NAR, you must apply for registration with the Washington State Health Department. An individual must also pass a criminal background check. According to federal and state law, an NAR is eligible to work in a licensed nursing home for up to 120 days while they enroll in their full certification program or await their full certification exam.

The NAC Goal: An NAC is the full certification for the nursing assistant license washington state. Earning your NAC certification ensures that you have satisfied the state’s stringent education and safety requirements. Your certification is entered into the state registry, giving you permanent professional licensure rather than the temporary licensure that the NAR provides.

Training Standards and Oversight

The Washington State Board of Nursing (WABON), which was previously known as the Nursing Care Quality Assurance Commission, regulates all the nursing assistant in washington state training programs. Washington State requires 108 hours of training, which is more rigorous than the federal 75-hour minimum training.

This 108-hour training is further divided into three areas:

Theory (35 hours): This area covers resident rights, infection control, and basic anatomy.
Lab (33 hours): This area covers hands-on training of skills in a controlled environment. This includes transfer techniques and vital signs.
Clinical (40 hours): This area covers the actual experience in a long-term care facility under the supervision of a licensed nurse.

However, the student must complete at least 16 hours of “Basic Safety and Rights” instruction before the start of the clinical experience. In addition, the 7-hour HIV/AIDS education segment is mandatory in Washington State, which is usually included in the curriculum.

The Washington CNA Exam and Registry

After completing your training from the approved Washington CNA training program, you must pass the National Nurse Aide Assessment Program (NNAAP). This Washington CNA exam is administered by Credentia in the state of Washington.

The exam is divided into two parts:

Written/Oral Exam: This is a 70-question multiple-choice exam. The test is available in an oral format if the individual cannot read or if English is their second language.

Skills Evaluation: This requires the individual to perform five randomly chosen nursing skills in front of the evaluator. These skills could be handwashing, blood pressure, range of motion, etc. The individual must pass all five skills to pass the test.

The individual has three attempts to pass the test within two years of completing the training program. Failure to pass the test within the three attempts will require the individual to take the entire 108-hour training program again. Once the individual passes the test, their name is registered, and the individual is officially issued the nursing assistant license washington state (NAC).

Renewal and Reinstatement Rules

Your Washington NAC certification is not permanent. It has to be renewed annually on your birthday. In addition, the requirement that it is renewed every year in the case of Washington ensures that there are frequent competency checks.

To qualify for cna license renewal washington, the following conditions have to be satisfied:

Work Requirement
You have to provide proof of at least 8 hours of paid nursing work in the last 48 months.

Continuing Education (CE)
You have to provide proof of completion of 12 hours of continuing education.

Health Equity Training
At least 2 hours of your continuing education has to be on the topic of health equity.

Fee
You have to pay the annual renewal fee of $75.

Reinstatement of Lapsed Licenses

If you fail to renew your license, your license will become “Expired.” However, if it has been less than 3 years since your license was last active, you will be able to reinstate your license by paying the late fees and providing proof that you satisfied the work and continuing education requirement. However, if your license has been inactive in the state of Washington for longer than 3 years, you will have to “start over” and retake a training program and pass the state exam again.

Reciprocity: Moving to Washington

If you are a certified nursing assistant in another state, you may qualify for Washington State CNA reciprocity, also known as “Interstate Endorsement.”

To qualify for endorsement, the following conditions have to be satisfied:

Active Status
You have to have an active and unencumbered certification in another U.S. state.

Verification
You have to get a verification form mailed directly to the Washington DOH from your current state’s certification agency.

Background Check
You have to pass the Washington State Patrol background check and, if you have not resided in the state, the FBI fingerprint check.

No Retesting
If your training meets the minimum requirement of 75 hours and your license is active, you will not have to retake the NNAAP exam.

What Makes Washington Different?

Washington is different in that it offers a dual credential system, NAR/NAC. This allows students to earn money as a “Registered” assistant while in school. In addition, the annual renewal cycle based on the individual’s birthday is unique, as most states prefer a two-year fixed cycle.

Washington (WA) Standard Summary

Requirement	Washington Standard
Total Training Hours	108 Hours
Clinical Minimum	40 Hours
Exam Provider	Credentia
Registry Authority	Department of Health (DOH)
Renewal Period	Annual (on birthday)
Reciprocity	Yes (Interstate Endorsement)

Maintaining compliance with WABON and the DOH is the only way to guarantee your ability to continue practicing. Remember to always verify your current status with the official Provider Credential Search before accepting any healthcare position, as working with a lapsed registration is a violation of the rules.

Frequently Asked Questions

• Do I need to be a U.S. citizen to become a CNA in Washington?
  No, but you must have a valid Social Security Number or an Individual Taxpayer Identification Number to apply for the credential with the Department of Health.
  
• Can I take the exam without completing the 108-hour program?
  Yes, in special “non-routine” cases. This is for nursing students that have completed at least one clinical rotation or military service as a Medic or Corpsman with training deemed equivalent to the state’s NAC curriculum.
  
• What happens if I forget to renew by my birthday?
  Your license will become “Expired” immediately at midnight. You cannot legally practice as a nursing assistant until the renewal is processed. If you continue to practice, you will permanently have a notation put on your registry record for practicing without a valid credential.
  
• Are there health requirements prior to the training?
  Yes. Most programs and sites require documentation of immunizations (MMR, Tdap, Hepatitis B) and a negative Tuberculosis (TB) test within the last 12 months.