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Since the process of reciprocity, or certification transfer, is so important to a certified nurse aide, we've decided to clarify what it actually is, when you need it, and how you may use it in the future. We start with the basic things you need to know about this process and then present the steps you must follow in order to apply for certification by reciprocity in a given state. It might seem like a long process at first but in fact there are only three essential steps you need to complete. You might want to bookmark or print this page in order to reference it later and make sure you check each step as you complete it.

What is reciprocity in nursing? Reciprocity is a process by which a certified nurse aide is able to transfer a CNA certification or license from one state to another. You must be already certified or licensed in one state in order to request reciprocity in another state. Example: you are certified as a nurse aide in the state of Texas and would like to be certified in California. When do you need to apply for reciprocity? Any time you want to work as a certified nurse aide (CNA) in a state other than your own state you must apply for certification in the new state. Example: you hold a nurse aide certification in New Jersey and want to move to New York where you wish to continue working as a CNA in a nursing home or licensed long term care facility.

Through the process of reciprocity, the new state reviews and approves your credentials (including nurse aide training and examination) and then lists your name on their nurse aide registry. This in turn gives you the right to practice as a certified nurse aide in the new state. Remember that by federal and state laws, only nurse assistants who hold certification may work in nursing homes or licensed long-term-care facilities.

Steps a CNA must complete to request reciprocity:

  1. Call the Nurse Aide Registry in your home state and request an "Application for Enrollment By Reciprocity". Ask them if you should send the completed form to them or to the state to which you are moving. The registry might ask for your mailing address or for your email address in order to send you the application. If you choose email address make sure you have it handy. If you receive this application by email make sure you are able to print it.
  2. Call the other state's Nurse Aide Registry, tell them you wish to apply for CNA Reciprocity, and ask them if you should send the completed "Application for Enrollment By Reciprocity" form to them. Some states wish to receive this application from the Nurse Aide Registry while other states accept it directly from you. Make sure you ask instead of taking any chances. Furthermore, ask and write down the name and phone numbers of those who you speak with for later reference.
  3. If the Nurse Aide Registry in the new state tells you it is acceptable for you to fax or mail the application and other necessary information, then do this immediately. Be sure to double check (read it back to the person you speak to) the fax number and the mailing address where you will send the information. Fax or mail your information to the attention of the individual you spoke to on the phone. Make sure you ask what items you need to fax or mail. Don't forget to tell them where they can mail your new CNA card. Along with your information it is wise to include a brief note thanking the person who took time to talk with you and ask them to call you if they need further information or if any problems arise.

Copies of the following items are usually asked for when you apply for reciprocity (if they ask for additional documents make sure to write them down for later reference). Do not send the original documents, only copies of these documents:

  • social security card;
  • drivers license (or a similar picture identification document);
  • your present CNA state approval;
  • a recent pay stub which shows that you have worked in a nursing home within the last two years.

What should you do if you get an automated line instead of a person when calling the Nurse Aide Registry? It is not unusual to get get an automated line when calling the C.N.A registry. Remember that the majority of those automated lines are toll free numbers and they can give you useful information. Listen to the recording, make the appropriate selection when prompted, and be ready to write down phone numbers should they provide any. It is always best to try to get a connection to a real person, so if they do have that option make sure you select it.

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Q: Can a CNA transfer from TX to TN?
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