How to Become a CNA in Nebraska

Becoming a CNA in Nebraska takes 75 hours of state-approved training, two competency exams, and placement on the Nebraska Nurse Aide Registry. There’s no application fee at any stage. This guide covers every step from enrollment to your first shift, including training costs, exam format, how the registry actually works, reciprocity for out-of-state CNAs, and what your career can look like from here.

If you’re still deciding whether this career is right for you, start with what a CNA actually does day to day before committing to training.

Nebraska CNA Requirements at a Glance

Here’s what Nebraska requires before you can work as a certified nurse aide.

Requirement	Details
Minimum age	16 (workers aged 16-17 cannot independently operate mechanical lifts; must be 18+ per DOL guidelines)
Training	75 hours state-approved training + 1 hour abuse/neglect/misappropriation training
Written exam	50 multiple-choice questions, 90-minute time limit, 70% passing score (35/50 correct)
Skills exam	6 skill demonstrations, 70% passing score on each, mandatory steps required
Attempts	3 per exam section; exhausting all 3 requires full course retake before testing again
Cost	$0 state application fee. Testing fees (approx. $100 total for written + skills) apply if not covered by an employer. Training ranges from $0 (employer-sponsored) to $1,500+ (community college)
Timeline	4-8 weeks training + approximately 3 weeks registry processing after passing exams
Criminal record	Background screening required (see Criminal Background Considerations below). $100 preliminary eligibility review available through DHHS.

According to Nebraska DHHS, there is no state application, registry, renewal, or reciprocity fee for nurse aides. Your actual out-of-pocket cost depends on training tuition and whether your employer covers testing fees. Confirm current testing pricing with NEHCA when you schedule your exam.

Each step is covered in detail below, starting with how to find and complete your training.

Complete an Approved Training Program

Nebraska requires 75 hours of CNA training at a state-approved facility. That training runs the range from free employer-sponsored programs to community college courses, and which path you choose can save you thousands of dollars.

What Training Covers

The 75-hour curriculum covers basic nursing skills, patient care, communication, and safety procedures, according to Nebraska DHHS. You also need one additional hour of training specifically on recognizing and reporting abuse, neglect, and misappropriation of resident property. This abuse-prevention hour is mandatory for every training pathway, including employer-sponsored programs.

One exception: if you plan to work only in an ICF/DD (intermediate care facility for individuals with developmental disabilities), a 21-hour basic resident care course is an approved alternative to the full 75-hour program.

Qualifications to enroll: you must be at least 16, have sufficient English proficiency, and pass a background screening. If you have a criminal record, see the next section before paying for any program.

Criminal Background Considerations

“Moral turpitude” in Nebraska generally includes felonies and misdemeanors involving dishonesty, fraud, theft, or harm to persons, but the determination is case-by-case. If you have a criminal record and are unsure whether it disqualifies you, the $100 preliminary conviction review through DHHS lets you check before paying for training.

The background screening involves a search of the Nebraska Criminal Clearinghouse and the Adult/Child Abuse and Neglect Central Registries. Registry eligibility and hiring eligibility are not the same. Even if DHHS allows certification, individual programs and employers may separately require fingerprint-based background checks, drug screening, TB testing, and immunization records before clinicals or employment. Ask each program for its full screening requirements before you enroll.

Training Pathways and Costs

Nebraska has three main training pathways. Costs vary significantly depending on which you choose.

Pathway	Typical Cost	Duration	Notes
Employer-sponsored	$0	4-8 weeks	Facility pays all costs; requires employment commitment after certification
Community college	$500-$1,500+	6-12 weeks	Central Community College, Northeast Community College, Bryan College of Health Sciences, Clarkson College, Mid-Plains Community College, and others
NHCLC (hybrid)	Check current pricing	5-6 weeks	Online classroom + in-person clinicals through Nebraska Health Care Learning Center, Lincoln office and statewide sites

One question that comes up often: can you take CNA classes online in Nebraska? Not fully. Nebraska requires hands-on clinical hours that cannot be completed online. The NHCLC hybrid format offers online classroom instruction paired with in-person clinical sessions, which is the closest available option.

Find the complete list of approved programs near you on the DHHS approved training sites list. With multiple options available through Nebraska CNA programs, our guide on how to choose the right CNA program can help you compare your options before committing.

If you are feeling a mix of excitement and nerves about starting your training, you are in good company.

“Hello.. my name is Eric and I’ve decided to embark on this journey to help people who need it.. also to help myself in the future and to care for my mother that is ill. I’m currently enrolled in a 4 week course and I’m feeling comfortable but anxious at the same time.”

(551 upvotes — Reddit user, r/cna)

That anxiety is normal and it fades fast once you start learning the hands-on skills. Here is what your training will actually cost if you go the employer-sponsored route.

Employer-Sponsored Programs (Free Training)

Employer-sponsored programs are especially common for people entering healthcare for the first time.

“For context I (20F) have been working as a CNA for a year now, said facility paid for my CNA training and was my first ever job as a CNA and in healthcare in general.”

— Reddit user, r/cna

Programs like CHI Health’s CNA Advance program cover tuition, fees, textbooks, scrubs, and the state certification fee in exchange for a one-year employment commitment after certification. Cross-training in phlebotomy is also available through some CHI Health facilities.

Nursing homes in Nebraska may also be required to cover your training costs under DHHS Medicaid Provider Bulletin 07-07, which documents employer reimbursement obligations under certain Medicaid funding conditions. This means the $0 training option is backed by federal Medicaid structure at many long-term care facilities across the state, not just one employer’s policy.

The one-year commitment is real, but so are the savings: employer-sponsored programs eliminate the upfront cost entirely, and you begin earning a paycheck while you train.

Pass the Nebraska CNA Exam

Nebraska’s CNA competency exam has two parts, and you need to pass both to be placed on the registry. For a general CNA exam overview covering what the test looks like across states, that resource is a useful starting point.

Written Exam

The written portion has 50 multiple-choice questions with a 90-minute time limit. You need a 70% score to pass, which means 35 correct answers out of 50, according to Nebraska DHHS. Questions cover material from your 75-hour training curriculum, including patient care, infection control, safety, and resident rights.

If you need an accommodation, an oral exam option is available. Ask your testing provider when you schedule.

The exam is administered through NEHCA Testing at the Lincoln office and statewide satellite testing sites. Before test day, work through a CNA practice exam to get familiar with question format and pacing.

Skills Demonstration

The skills portion is where most candidates feel the most pressure. The evaluator will randomly select 6 skills from the pool of 45 basic nursing assistant skills, and you must demonstrate each correctly.

Passing threshold: 70% on each skill. Some skills have mandatory steps that must be performed correctly regardless of your overall score on that skill. If you miss a mandatory step, you fail that skill even if everything else is right.

The Nebraska Health Care Learning Center offers on-demand skills review videos for all 45 nurse aide skills. Our CNA skills test guide breaks down what evaluators look for on each skill. For a structured study plan beyond the NHCLC videos, see our guide on how to study for the CNA exam.

The exam pressure is real, but so is the relief on the other side.

“just wanted to say i’ve officially passed all the tests and i am a registered cna. i’m 17 in HS and went through a career and technology program in my school where i can get my cna. i’m low key proud of myself… to anyone else reading this: you’re doing amazing!”

(671 upvotes — Reddit user, r/cna)

With both exams passed, your name goes on the Nebraska Nurse Aide Registry automatically. Here’s what that process looks like.

What Happens If You Don’t Pass

You have three attempts per section before you’re required to retake the full 75-hour training course, per Nebraska DHHS. Failing one section doesn’t affect the other. But if you exhaust all three attempts on either section, you start the course over before testing again.

Nebraska does not publish state-level pass rate data. The best preparation is consistent skills practice and written review before you sit for either section.

If you need to schedule a second or third attempt, our guide on retaking the CNA exam covers what to study differently and how to approach the skills section after a first attempt.

Get on the Nebraska Nurse Aide Registry

After you pass both exams, you don’t need to apply for anything. DHHS adds you to the Nebraska Nurse Aide Registry automatically.

There are no fees for nurse aides at any stage of this process, according to Nebraska DHHS. Expect approximately three weeks after passing both exams before your name appears on the registry.

To verify your listing, search the Nebraska Nurse Aide Registry by your first and last name. Nebraska does not issue a physical license card. Log into the registry portal and click the “Generate Wallet Card” button to print your credential. Your employer will verify your status through the same portal before you start work.

Getting on the registry is the straightforward part. Staying on it and understanding what your status means is what the next section covers.

How the Nebraska Nurse Aide Registry Works

The Nebraska Nurse Aide Registry is the official record of everyone certified to work as a nurse aide in the state. Understanding how it works matters more than most CNAs realize, especially the 24-month employment rule that determines whether you can legally work.

How to Look Up Your Status

Search the Nebraska Nurse Aide Registry by entering your first and last name. The portal shows your current registry status, any findings on your record, and your certification details. Employers use this exact portal to verify your credentials before hiring, so what you see is what they see.

From the registry, you can also generate your wallet card directly. There’s no separate credential document mailed to you. The “Generate Wallet Card” button on your registry record is how you get your portable proof of certification.

The registry is public and free to access. No login is required for a CNA license lookup in Nebraska.

Registry Status Types

Nebraska tracks three registry status types. Each has different implications for your ability to work, according to Nebraska DHHS.

Status	What it means	Can you work?	What to do
Active	Passed exams AND worked paid CNA shifts at an approved employer setting within the past 24 months	Yes	Maintain by continuing to work at approved settings
Lapsed	On the registry but no record of paid CNA employment at an approved setting in the past 24 months	No	Contact a recompetency provider, pass both exams, wait ~3 weeks
Ineligible	A finding of abuse, neglect, or misappropriation, or a disqualifying criminal conviction on record	No	Requires formal review; not a standard reactivation process

Lapsed and Ineligible are fundamentally different situations. Lapsed is a maintenance issue. Ineligible is a disqualifying finding. Don’t treat them as interchangeable when planning your next steps.

How to Stay Active

Maintaining Active status in Nebraska does not require a renewal form, a fee, or continuing education. Your employment record IS your renewal.

The requirement: work at least one paid shift as a nurse aide at an approved employer setting within every 24-month window. Volunteer work, unpaid clinical hours, and employment at non-approved facilities do not count. The DHHS approved employer settings PDF lists the specific facility types that qualify.

Do not assume any caregiving job counts. Nursing facilities, hospitals, and other DHHS-approved settings qualify, but private-duty caregiving, unpaid work, student clinicals, and many non-facility roles do not. Before accepting a job, compare the employer type against the DHHS approved employer settings list. If your hours are not appearing on the registry, your employer may not have reported them. You can submit a Nurse Aide Employment Verification form to DHHS directly.

Staying active on the registry means working at least one paid CNA shift within every 24-month window. That’s the minimum, but the reality of CNA work is demanding.

“I wonder how many CNAs quit after this”

(4,223 upvotes — Reddit user, r/nursing)

If the 24-month window passes and your status lapses, the path back is shorter than you might expect.

What to Do If Your Status Lapses

A Lapsed status is not permanent and does not require you to retake the full 75-hour training course, per Nebraska DHHS Requirements. Here’s the reactivation process:

1. Contact an approved post-secondary recompetency provider from the DHHS recompetency provider list.
2. Schedule both the written/oral exam and the clinical skills exam. Both exams can be completed on the same day.
3. Pass both exams using the same 70% threshold as initial certification.
4. Wait approximately three weeks for DHHS to update your registry status.

One exception: if you were grandfathered onto the registry before 1989 with only 30 hours of training, you must complete the full 75-hour program before recompetency testing.

Alternative pathways to the registry for specific situations, per the DHHS Nurse Aide Requirements page:
– Nursing students: Submit transcript and cover letter to DHHS. Grades below 70% require standard competency exams.
– Foreign-trained nurses: Complete a CGFNS credential evaluation, pass both competency exams, and complete abuse training.
– Inactive or lapsed RNs or LPNs who have been unlicensed more than 24 months: submit a cover letter, complete abuse training, and pass both exams.

Transferring Your CNA to Nebraska (Reciprocity)

Nebraska accepts CNA credentials from other states through interstate endorsement. There’s no fee, and the process takes up to 30 days, according to Nebraska DHHS.

Nebraska calls this process “Interstate Endorsement.” Both “reciprocity” and “interstate endorsement” refer to the same process. Using either term when contacting DHHS will work.

Steps to complete your Nebraska CNA reciprocity:

1. Confirm your CNA status is Active in your originating state. Nebraska will not process an endorsement for a lapsed or ineligible certification.
2. Download and complete the Interstate Endorsement Application from DHHS.
3. Complete the 1-hour Nebraska abuse, neglect, and misappropriation prevention training. This is required for all interstate endorsements, even if you completed similar training in your originating state.
4. Submit the completed application to DHHS by fax or mail.
5. Wait up to 30 days for processing. During this time, DHHS verifies your registration with your originating state and any other states where you have worked as a nurse aide.

One practical tip directly from DHHS: fax documents on white paper only. Colored paper does not scan or transmit well and can delay your application.

You must be listed on the Nebraska Nurse Aide Registry before you can legally work in a certified Nebraska nursing facility. Don’t start work before your endorsement is processed.

Transferring Your Nebraska CNA to Another State

If you’re leaving Nebraska, the receiving state controls the transfer process. Nebraska doesn’t have a standardized outgoing verification form. The new state will contact Nebraska DHHS directly if they need to verify your credentials.

To get started, contact the nurse aide registry in your destination state. The NCSBN State Board Contact Directory lists every state’s registry contact information. Requirements, fees, and timelines vary by state, so check with the receiving state before assuming the process mirrors Nebraska’s free endorsement.

Make sure your Nebraska certification is Active before initiating the transfer. A Lapsed certification cannot be transferred until reactivated. Print your wallet card from the Nebraska Nurse Aide Registry to have portable documentation ready when the new state requests proof of your credentials.

Nebraska CNA Salary and Career Outlook

The median CNA salary in Nebraska is $18.19 per hour ($37,840 per year), according to the Bureau of Labor Statistics. That’s the statewide staff position baseline.

Pay Type	Amount	Source
Median hourly (staff)	$18.19/hr	BLS OES
Median annual (staff)	$37,840/yr	BLS OES
Per diem / agency	~$33/hr	AMN Healthcare job postings

Per diem and agency CNAs in Nebraska earn around $33 per hour on average, according to AMN Healthcare. Those shifts don’t come with benefits, and scheduling is less predictable, but the hourly difference is significant.

These numbers tell part of the story. CNA pay is a consistent concern across the profession.

“CNA salaries are already at least a decade behind what they should be… I’ve only made around 13K in the past 6 months as a PCT, and that’s on full time night shift! Looked up my hospitals profits, and they make 98 million profit AFTER paying salaries and other costs.”

(224 upvotes — Reddit user, r/cna)

Being honest about pay is important because it helps you plan. Here is where the career path gets more interesting: Nebraska offers a clear advancement pipeline.

Working conditions vary significantly between facilities, and staffing ratios are something experienced CNAs pay close attention to.

“I refused an unsafe assignment and walked out. I was supposed to be working last night 10-6. Get there and find out it’s me and 3 cnas for 68 residents, I would have 4 carts. SIXTY EIGHT.”

— Reddit user, r/nursing

Nebraska’s strong CNA demand, especially in rural areas, means you have options when choosing where to work. Understanding CNA patient ratios can help you evaluate potential employers before accepting a position.

Career ladder in Nebraska:
– CNA (starting point, $18.19/hr median)
– Medication Aide (first step up; NHCLC offers medication aide training in Nebraska)
– LPN (community college program, approximately 1 year)
– RN (associate or bachelor’s degree, 2-4 years)

The CNA is a starting point, not a ceiling. Cross-training in phlebotomy is available through facilities like CHI Health, expanding your skills without a separate degree.

For metro-area salary breakdowns and a closer look at what advancement from CNA to LPN to RN looks like in Nebraska specifically, see why become a CNA in Nebraska. What you earn from day one depends heavily on facility type: rural facilities often have stronger demand and more schedule flexibility than metro areas, which matters when you’re choosing where to start.

For questions about certification, renewal, or reactivation, Nebraska DHHS can be reached at (402) 471-4322 or [email protected], Monday-Friday 8:00 AM to 5:00 PM.