1. A. Initial Certification. An applicant for initial nursing assistant certification shall have successfully:

   1. (1) Completed:

      1. (a) An approved nursing assistant training program;
      2. (b) An approved acute care nursing assistant training program;
      3. (c) A portion of an approved nursing education program that has been determined by the Board to meet the requirements of a nursing assistant training program set by the Board; or
      4. (d) Service member training and education that has been determined by the Board to be substantially equivalent to a nursing assistant training program approved by the Board in accordance with Health Occupations Article, §1-702, Annotated Code of Maryland; and
   2. (2) Passed a nursing assistant competency evaluation.

2. B. Certification by Endorsement. An applicant for nursing assistant certification by endorsement shall:

   1. (1) Hold a certificate to practice as a nursing assistant that:

      1. (a) Was issued by another state or territory of the United States that has certification requirements that are essentially similar to those set forth in Health Occupations Article, §8-6A-05, Annotated Code of Maryland; and
      2. (b) Is in good standing; and
   2. (2) Have successfully completed a nursing assistant training program that meets the standards for an approved nursing assistant training program set by the Board.

3. C. Any applicant for nursing assistant certification may not have:

   1. (1) Committed any act or omission that would be grounds for discipline or denial of certification under Health Occupations Article, §8-6A-10, Annotated Code of Maryland; or
   2. (2) A record of abuse, negligence, or misappropriation of a client's property or any disciplinary action taken or pending in any other state or territory of the United States against the certification of the CNA.

4. D. Nursing Education Programs.

   1. (1) To meet the requirements of a nursing assistant training program set by the Board, a portion of a nursing education program must include courses with content that primarily focuses on:

      1. (a) Nursing fundamentals;
      2. (b) Mental health;
      3. (c) Health assessment;
      4. (d) Nursing ethics; and
      5. (e) The content listed under 42 CFR §483.152(b).
   2. (2) If a portion of a nursing education program does not include courses with content that primarily focuses on the subject matters set forth in § D(1) of this regulation, the Board may review and approve other equivalent subject matters as meeting the requirements of a nursing assistant training program set by the Board.
5. E. A CNA-II who seeks certification as a CNA-1 shall meet the qualifications set forth in §A of this regulation.

6. F. Temporary Nurse Aides.

   1. (1) A temporary nurse aide applying for certification as a CNA-1 shall be deemed to have completed a nursing assistant training program approved by the Board if the temporary nurse aide:

      1. (a) Completed a temporary nurse aide training course;

      2. (b) Completed a minimum of 100 hours of on-the-job training as a temporary nurse aide that:

         1. (i) Met the requirements under 42 CFR §483.152(a) and 42 CFR §483.152(b)(2)—(7); and
         2. (ii) Was not provided in a facility described under 42 CFR §483.151(b)(2)—(3); and
      3. (c) In addition to the minimum 100 hours of on-the-job training, worked as a temporary nurse aide competently for a minimum of 160 hours.
   2. (2) A temporary nurse aide whose on-the-job training did not meet all of the requirements under 42 CFR 483.152(a) and 42 CFR 483.152(b)(2)—(7) may receive supplemental training in those requirements and be deemed to meet the requirement of §F(1)(b)(i) of this regulation.

Authority: Health Occupations Article, §§8-205, 8-206, and 8-6A-01—8-6A-17, Annotated Code of Maryland; Ch. 486, Acts of 2012;
Chs. 818 and 819, Acts of 2024; Ch. 416, Acts of 2025

Effective date: February 5, 2001 (28:2 Md. R. 100)

Regulation .01B amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825)

Regulations .02A, .06B, .09B amended as an emergency provision effective November 15, 2001 (28:24 Md. R. 2125); amended permanently effective February 18, 2002 (29:3 Md. R. 221)

Regulation .02A amended effective February 2, 2004 (31:2 Md. R. 85); August 27, 2007 (34:17 Md. R. 1509)

Regulation .03 amended effective April 24, 2006 (33:8 Md. R. 734)

Regulation .04 amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825)

Regulation .04D amended effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .06 amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825)

Regulation .06 amended effective August 25, 2008 (35:17 Md. R. 1489); April 19, 2010 (37:8 Md. R. 617)

Regulation .06H amended effective January 6, 2014 (40:26 Md. R. 2164)

Regulation .06N amended effective June 13, 2011 (38:12 Md. R. 705)

Regulation .07 amended effective April 19, 2010 (37:8 Md. R. 617)

Regulation .08 repealed and Regulation .09 recodified to be Regulation .08 effective April 24, 2006 (33:8 Md. R. 734)

Regulation .08 amended as an emergency provision effective January 2, 2007 (34:4 Md. R. 397); amended permanently effective May 7, 2007 (34:9 Md. R. 825)

Regulation .08A, B amended effective April 7, 2008 (35:7 Md. R. 748)

Regulation .08D amended effective March 22, 2010 (37:6 Md. R. 478)

Regulation .10 repealed effective April 24, 2006 (33:8 Md. R. 734)

Chapter revised effective February 13, 2017 (44:3 Md. R. 189)

Regulation .01B amended effective July 2, 2018 (45:13 Md. R. 667)

Regulation .01B amended as an emergency provision effective September 22, 2022 (49:22 Md. R. 975); emergency status expired effective March 30, 2023

Regulation .04D adopted as an emergency provision effective September 22, 2022 (49:22 Md. R. 975); emergency status expired effective March 30, 2023

Regulation .05 amended effective July 2, 2018 (45:13 Md. R. 667)

Regulation .05 amended as an emergency provision effective September 22, 2022 (49:22 Md. R. 975); emergency status expired effective March 30, 2023

Regulation .07 amended effective July 2, 2018 (45:13 Md. R. 667)

Regulation .08 amended effective July 2, 2018 (45:13 Md. R. 667)

Regulation .09 amended effective July 2, 2018 (45:13 Md. R. 667)

Regulation .09A amended as an emergency provision effective September 22, 2022 (49:22 Md. R. 975); emergency status expired effective March 30, 2023

Chapter revised as an emergency provision effective April 3, 2026 (53:9 Md. R. 411); amended permanently effective June 8, 2026 (53:11 Md. R. 484)