3.1 CNA Scope of Practice in Florida

The Florida CNA Role

A Florida Certified Nursing Assistant (CNA) gives hands-on personal care under the supervision of a licensed nurse. You become a CNA by passing the two-part Prometric competency exam — a 60-question written (or oral) test and a manual skills evaluation of five randomly selected skills — and you are then placed on the Florida Nurse Aide Registry — maintained by the Florida Department of Health / Board of Nursing, with Prometric administering it under contract. You must be in good standing on that registry to work as a nurse aide in a Florida nursing facility.

Florida is unusual in allowing the exam-challenge route (Prometric candidate type E3), so a candidate can sit the exam without completing a state-approved training program. Either way, the legal role is identical once you are certified.

Scope of practice is the set of tasks that Florida law, your supervising nurse, and your facility allow you to perform based on your training and certification. CNAs are unlicensed assistive personnel: you do not hold a license and you do not practice independently. Everything you do flows from a nurse's delegation. The exam's Role of the Nurse Aide content is one of the heaviest written areas, and most questions simply reward staying inside scope.

Tasks Within Florida CNA Scope

Acts Outside Florida CNA Scope

The dividing line is the nursing process: assessment, nursing diagnosis, planning, and evaluation can never be delegated to a CNA because they require a nurse's specialized knowledge and judgment. Anything invasive, sterile, or requiring a clinical decision is also off-limits.

Note one Florida nuance: a 2022 law (HB 413) lets a nurse delegate the administration of certain routine medications to a trained, qualified CNA in some home and community settings — but only after specific delegation, documentation, and training requirements are met. On the exam and in a standard nursing facility, treat medication administration as outside your scope unless your nurse has specifically delegated and trained you under that rule.

Reporting Changes Is Always In Scope

Noticing and reporting a change is the one task a Florida CNA must never skip. If a resident has new confusion, a new reddened area, a fall, chest pain, or sudden weakness, the correct action is to keep the resident safe and tell the nurse promptly. The CNA does not decide what the change means and does not treat it.

Example: a resident's lower leg is newly swollen, red, and warm. The Florida CNA reports it to the nurse immediately. The CNA does not massage the leg, apply heat, elevate it on their own judgment, or reassure the resident that it is "probably just a strain." Massaging a hot, swollen calf could dislodge a clot — exactly the kind of clinical reasoning reserved for the nurse.

When Two Rules Conflict

State training, facility policy, and the supervising nurse can each limit what you do, and they do not always match. A skill you learned in class may still be off-limits at a particular facility, and a nurse may further restrict it for an unstable resident. When the rules differ, follow the most restrictive one and ask the nurse. Performing an out-of-scope act in Florida can lead to resident harm, AHCA registry discipline (including being flagged for abuse, neglect, or exploitation), and termination — even if a coworker or family member told you to do it. "Someone told me to" is never a defense for an aide who acts outside scope.

Staying On The Registry

Florida certification lasts two years and renews on a biennial cycle (renewal is due by May 31 of your renewal year). To recertify you must complete at least 24 hours of in-service / continuing education during the two-year period and show recent paid nurse-aide work. Letting certification lapse, or being placed on the registry's findings section for misconduct, removes you from the eligible-to-work pool. Knowing these registry facts is fair game on the written exam.

Quick Scope Self-Check

Before any task, run a three-question test:

1. Is it on my permitted list and have I been trained on it? If no, stop.
2. Does it require a clinical decision, a sterile field, an invasive step, or a medication? If yes, it belongs to the nurse.
3. Has the nurse delegated it for this resident right now? If unsure, ask before acting.

If all three clear, proceed and report back. If any fail, decline professionally and route the task to the nurse.