Transition from Temporary Nurse Aide (TNA) to Certified Nurse Aide (CNA)

This process is intended to expedite the transition of individuals who have served as Temporary Nurse Aides (TNAs) at long term care facilities (nursing homes) to Certified Nurse Aides (CNAs).  This expedited process will allow a TNA to become certified (CNA) without having to complete an approved Nurse Aide Training Program.  To maintain the current standards of public safety, the TNA is required to successfully complete the Nurse Aide Competency Evaluation administered by Prometric to be certified to the LA Nurse Aide Registry. 


08/29/2022 Update to MemoCMS QSO-22-15-NH & NLTC & LSC

04/08/2022 Memo: LDH Clarification of TNA expiration dates

04/07/2022 Memo: CMS  QSO-22-15-NH & NLTC & LSC

04/07/2022 Prometric/LDH Webinar for Nursing Home providers 


Please note: 

  • The use of TNA's was granted by CMS, per the CMS Waiver. Refer to the CMS Waiver for updates. THE ABILITY TO USE TNA'S IS NOT DETERMINED NOR MANDATED BY LDH.
  • The TNA to CNA Transition Process was implemented by LDH. Based upon CMS guidance in CMS Memo QSO-21-17-NH, facilities will have 4 months from the date of the CMS Waiver expiration to ensure TNA's are certified.
**NEW AS OF 04/07/22**
  • Per CMS Memo QSO-22-15-NH & NLTC & LSC, dated April 7, 2022, the use of TNA's will expire on June 7,2022, and TNA to CNA Transition Process will expire 4 months after that. 
  • Therefore, all TNA's must be tested by October 7, 2022. 
  • The CMS Memo QSO-22-15-NH & NLTC & LSC does allow for exceptions to this date, if the state experiences testing backlogs.  The facility must have documentation to verify all steps taken to schedule testing in a reasonable timeframe. 
  • Additionally, the program desk must be notified of issues that may result in facility's inability to meet the deadline of October 7, 2022 (i.e., testing backlogs).  Submit to    

Eligibility for TNA to CNA Transition Process Requirements:

  1. (Minimum) 8 hours of temporary nurse aide training course or equivalent; 
  2. (Minimum) 16 hours skills competency verification PRIOR TO DIRECT RESIDENT CONTACT;
  3. (Minimum) 60 hours of on the job training/work as a TNA in a NH/SNF; and
  4. Currently employed as a TNA.

Once the TNA has met requirements, the TNA is eligible to test for certification to the LA Nurse Aide Registry.

  1. The facility (nursing home) must submit the TNA to CNA Verification Form with names of TNA’s eligible for the TNA to CNA Transition Process to the LA Nurse Aide Registry (LA-NAR) at  DO NOT include TNA's that have already been approved (i.e. for retesting); DO NOT scan the form--submit electronically. 
  2. The LA-NAR will send a verification email to the facility which will include information required on the Prometric application and any updates to the process.
  3. After approval is received from the LA-NAR, the facility must submit the application and test fees to Prometric in order to schedule test for the TNA candidates.
  4. Prometric cannot schedule if the application is incomplete.  Incomplete status examples include missing fee, incomplete demographics, missing email address, no test site, any illegible information, etc. 
  5. Once application is processed, Prometric will send notification to the email address provided on the application of status (either complete or incomplete). Therefore, ensure the email address is correct, legible, and notify owner of the email address to expect it. 
  6. If your facility is approved as an IFT, submit IFT request to Prometric using normal procedure.
  7. If TNA is terminated after approval by LDH, notification must be submitted to LA-NAR email.  If Prometric application has been submitted, Prometric should be notified that candidate is no longer eligible to test. 

 Prometric-preparation for testing:

  1. For NH’s that are not familiar with Prometric, the TNA to CNA Competency Test Preparation Guide provides an overview of the Prometric competency evaluation process.
  2. The NH should ensure the TNA is adequately prepared for the competency evaluation. Resources include the TNA to CNA Competency Test Preparation Guide as well as information on the Prometric website.
  3. If TNA must re-test, they do NOT need to be submitted and approved by the Registry. 
  4. The TNA has three (3) opportunities to pass both portions of the competency test.
  5. If unsuccessful after 3 attempts, the TNA is no longer eligible for TNA to CNA Transition and must attend an approved Nurse Aide Training Program to test again.

Test site info

  1. In-facility test site (for approved NATP's or sister facility of an NATP)
    1. Nurse Aide Evaluator (NAE/tester) comes to your facility to administer the competency test to TNAs
    2. Minimum of 4 TNA candidates required for a test event
    3. Facility is able to request date of the test event
    4. Test administered in familiar setting, which leads to decreased anxiety and better test results for candidates
  2. Regional test site
    1. Candidate (i.e., TNA) is scheduled “first come, first serve” into the next available test event at the regional test site chosen on the application
    2. Cannot choose test date 

TNA to CNA Verification Form and Other Information

1. The TNA to CNA Verification Form must be submitted and approved by the LA Nurse Aide Registry prior to submission of scheduling the test with Prometric. Do not scan; save form and email to

2. Submission of the TNA to CNA Verification Form serves as attestation that the individuals have met the requirements of the TNA to CNA Transition process and are eligible to take the Nurse Aide Competency Evaluation administered by Prometric. 

3. Any candidate tested under TNA school code that was not submitted and approved by the LA-NAR will NOT be certified to the LA Nurse Aide Registry, regardless of the results of the competency evaluation.

4. If facility has a traditional Nurse Aide Training Program, TNA's are NOT to be submitted using the NATP code.  TNA candidates must test using the TNA School Code.  The code will be provided in the approval email from the LDH. 

**Please note: During a survey, facilities must provide verification that training of any candidates tested using the NATP Code was conducted per the NATP approval (i.e., curriculum, program hours, schedule, instructors, etc.).  TNA's tested using the TNA School Code only require documentation of minimum TNA to CNA training requirements (as noted above).  

To ensure certification of only those TNA's that are currently employed, immediately report to the LDH the termination of TNA's that have been submitted/approved for testing by email to If Prometric application has been submitted, Prometric must be notified as well. 

Please direct any questions or concerns to Ash-Leigh Garcia, RN, Program Manager:


NATP and Registry Quick Links

Prometric website for LA

LDH-Prometric website

New Nurse Aide Training Program approval information

NATP Change Information for currently approved programs (instructions for reporting program changes)

COVID19/Nurse Aide Training/TNA Waiver information

TNA to CNA Transition 

Train the Trainer contacts 


LA Nurse Aide Registry online CNA verification

LA Adverse Actions website (DSW findings)

LA Nurse Aide Registry website (information for CNA's)

CNA recertification testing information

State Minimum Licensing regulations for Nurse Aide Training and Competency Evaluation Programs LAC 48:1 Chapter 100

Federal regulations for Nurse Aide Training and Competency Evaluation Programs CFR, Chapter IV, Subchapter G, Part 483, Subpart D

LDH Contact information