CNA Training: The Hidden Factor That Determines the Quality of Your Loved One’s Care

When you tour a long-term care community, everything looks welcoming. You see spacious rooms, a sunny dining area, and a busy activity calendar. You might even ask about nurse-to-patient ratios or how often doctors visit.

Much of the care happens when you are not around to watch. There’s one crucial question most families never ask: Who will actually be caring for your loved one during the 80 to 90 percent of the time that isn’t medical care?

The answer is usually Certified Nursing Assistants (CNAs). Licensed and trained CNAs, and the quality of their training can make or break your parent’s daily living experience. CNAs help with bathing, dressing, eating, mobility, and preserving dignity in the most personal moments of care. Yet, CNA training rarely comes up in tours or brochures.

CNAs are the backbone of long-term care. They see and touch patients more than anyone else. Their skill and compassion can make the difference between a good day and a bad one for a resident.

They spend more time with residents than anyone else. And they know residents better than the nurses, and way better than the doctors. — Lori Porter, National Association of Health Care Assistants co-founder/CEO.

Why CNA Training Matters More Than Amenities

CNAs deliver most hands-on care in nursing homes, assisted living facilities, and memory care communities. While registered nurses and physicians make medical decisions, CNAs are the ones who:

• Help residents with daily living tasks
• Notice subtle health changes early
• Prevent falls and infections
• Offer emotional reassurance during vulnerable moments

Research consistently shows that facilities with comprehensive ongoing CNA training programs report significantly fewer patient safety incidents and better overall resident satisfaction. Yet, most families focus on amenities, location, and overlooking the staff who have the most contact with their loved ones.

What CNA Certification Really Means

Federal OBRA standards from 1987 require a minimum of 75 training hours for CNAs. But that’s just the baseline. Many states have expanded requirements, with training ranging from 120 to 175 hours.

A quality CNA training program includes:

• Classroom education on medical fundamentals
• Skills labs for hands-on practice
• Supervised clinical rotations with real patients

Core CNA skills include:

• Infection control and hand hygiene
• Safe transfers and mobility assistance
• Monitoring vital signs
• Providing personal care with dignity
• Communicating with residents with dementia
• Recognizing and reporting changes in condition

After training, CNAs must pass both a written exam and a hands-on skills demonstration covering more than 25 procedures — from handwashing to feeding and catheter care. This rigorous testing ensures competency, but not all facilities hold their staff to higher standards.

Testing

After completing training, CNA candidates must pass both a written exam and a hands-on skills demonstration. The hands-on evaluation is rigorous as candidates must flawlessly demonstrate everything from proper handwashing to catheter care, patient positioning to feeding assistance.

Testing providers evaluate 25+ specific skills, watching for precise technique, safety protocols, and patient communication throughout each demonstration.

Understanding these CNA skills test requirements helps families appreciate the level of competence a certified CNA should bring to patient care.

How to Spot Red Flags in CNA Staffing

Not every facility prioritizes CNA quality equally. Warning signs include:

• Over-reliance on “trainees” who aren’t fully certified
• High CNA turnover rates (above industry average of 65–70%)
• Little or no continuing education
• Vague or evasive answers about training standards

Facilities that treat CNAs as interchangeable workers rather than skilled professionals are more likely to experience inconsistent care, increased safety risks, and resident dissatisfaction.

Five Questions to Ask Before Choosing a Facility

You have every right to ask tough questions. Quality communities will welcome them.

1. “What percentage of your CNAs are fully certified versus in training?”
2. If more than 15–20 percent are uncertified trainees, ask how quickly they advance to certification.
3. “What is your CNA retention rate?”
4. Consistent caregivers mean more personalized care. A retention rate below 50 percent is a strong indicator of stability.
5. “Do you provide ongoing CNA education beyond initial certification?”
6. Look for structured in-service training, dementia care programs, and quarterly refreshers.
7. “How do you support CNAs in passing their state exam?”
8. Quality facilities often offer paid study time and reimbursement of exam fees.
9. “Can I observe CNAs during regular care hours?”
10. Tours don’t tell the full story. Watch how CNAs interact with residents. Do they communicate clearly, respect dignity, and work patiently?

Why CNA Training Standards Protect Your Loved One

A well-trained CNA isn’t just helping with hygiene; they’re the frontline health observers. They notice:

• Changes in mobility that could signal fall risk
• Confusion that may indicate infection
• Subtle shifts in mood or appetite that flag underlying issues

Facilities that invest in CNA training and professional development reduce hospital readmissions, prevent avoidable injuries, and help residents maintain their independence longer.

Share your thoughts and experiences about aging, caregiving, health, retirement, and long-term care with LTC News —Contact LTC News.

Workforce Pressure: Why Families Must Ask

The CNA workforce is under strain nationwide. Demand for care far outpaces supply, and facilities face mounting pressure to fill shifts quickly. But lowering training standards to meet staffing needs comes at a cost to residents.

Experts suggest that families need to know that asking about CNA training isn’t nitpicking; it’s about protecting their loved one. A well-trained CNA can spot what others might miss.

When families consistently ask about CNA standards, facilities recognize that quality care is a competitive advantage. That pressure can drive positive change across the industry.

A Smart Next Step: Check Credentials and Compare

Before choosing a facility, learn your state’s CNA training requirements. Then, compare facilities using those benchmarks. Be sure to use the LTC News Caregiver Directory to find licensed and well-rated care providers in your area.

• Find assisted living facilities near you.

When you evaluate care through the lens of CNA quality, you’re making an informed choice, not just picking based on surface impressions.

The Real Heart of Quality Care

A beautiful lobby or a good meal plan doesn’t guarantee safety or dignity. People do. CNAs are the hands and hearts of long-term care. Their training, respect, and stability determines whether your parent feels safe, respected, and truly cared for.

When you walk through a facility for the first time, remember: You’re not just choosing a place. You’re choosing the people who will care for someone you love every single day.

Better facilities hire better staff. While the facility's cost may be higher, your loved one's overall quality of life will usually be much better. If your loved one has a Long-Term Care Insurance policy, that extra expense can be easier to afford.

Learn More: How Does Long-Term Care Insurance Work?

• Key Takeaway: Ask about CNA certification rates, training programs, turnover, and observation opportunities during your search. Your loved one’s daily experience depends on it.
• Resource: LTC News Caregiver Directory – Find qualified caregivers and compare facilities in your area.
• Get help: Need help filing a claim? LTC News partners with Amada Senior Care to provide free claim support with no cost or obligation. Their trained experts can walk you through the entire process and help you access benefits quickly and correctly — File a Long-Term Care Insurance Claim.