Keeping Your CNA Active in 2027: The Nurse Aide Registry and the 24-Month Rule

What the registry is, and what it records

Every state keeps a nurse aide registry. Under 42 CFR 483.156, it must include at least your full name, information that identifies you, and the date you became eligible to be listed, which is usually the date you passed the competency exam. It also records any finding of abuse, neglect, or misappropriation of resident property, along with your statement disputing it if you made one. The state may not charge you to be listed.

Employers use the registry before hiring you, and nursing homes must check every state registry they believe may have information about you. Your registry status, not a wallet card, is what proves you can work.

The federal 24-month rule, in two parts

Federal rules attach two consequences to a long gap in work:

1. The registry removes you. The state must remove the entry of anyone who has performed no nursing or nursing-related services for 24 consecutive months. The exception is an entry with a documented finding, which stays.
2. The employer must retrain you. A nursing home can't use you as a nurse aide if you've gone 24 consecutive months without paid nursing or nursing-related services, until you complete a new training and competency evaluation program, or a new competency evaluation.

The key word in the second rule is paid. Caring for a family member doesn't keep you active under the employer rule.

How one state turns that into renewal rules

States decide how you prove the work. Pennsylvania's Credentia FAQ is a clear example:

Other states use different periods, forms, or fees. Check your own state's registry page for the renewal steps that apply to you.

Moving to another state

Registries are state-run, so moving usually means applying to the new state's registry, often through a reciprocity route. Tennessee, for example, has a reciprocity route with no exam: Credentia checks your status in each state you list and checks abuse registries there, and Tennessee doesn't accept Florida-issued certifications for reciprocity. Pennsylvania's FAQ says a nurse aide whose listing has lapsed in another state must first be updated on that original registry before reciprocity is possible. Keeping your current registry active makes any move easier.

Findings don't expire

A substantiated finding of abuse, neglect, or misappropriation stays on the registry permanently, unless it was made in error, you were found not guilty in court, or the state is notified of your death. Federal rules bar nursing homes from employing anyone with such a finding. That is a lasting reason to know the abuse and reporting rules well, not just for the exam.

Staying competent while you stay active

Keeping your listing active is the floor. Federal rules also require nursing homes to review each nurse aide's performance at least once every 12 months and provide at least 12 hours of in-service training a year, including dementia management and abuse prevention. The scope and reporting guide covers what you're expected to keep doing well.

A 2027 checklist

• Look up your registry entry and note your eligibility date and any expiration date shown.
• Count back 24 months from your last documented paid shift in an approved setting.
• If 2027 will mark 24 months without qualifying work, find a shift or contact the registry about your options before you lapse.
• Keep your own copies of employment records that show dates and settings.
• If you're moving in 2027, start the reciprocity application while your current status is active.