1.3 The Indiana Nurse Aide Registry (INAR): Listing, Renewal, Work Requirement, Findings, and Reciprocity

The Indiana Nurse Aide Registry (INAR)

Quick Answer: The Indiana Nurse Aide Registry (INAR) is the official state record of every CNA certified to work in Indiana licensed health facilities. It is maintained by the Indiana Professional Licensing Agency (IPLA) in cooperation with the Indiana Department of Health (IDOH). To stay on the registry, a CNA must renew every 2 years and must have performed at least 8 hours of paid nursing or nursing-related work in the preceding 24 months. A substantiated finding of abuse, neglect, or misappropriation is listed on the registry and bars the aide from employment in Indiana LTC facilities.

What the Registry Is and Who Maintains It

The INAR is the legal record of who is qualified to work as a CNA in Indiana's licensed long-term care facilities — nursing facilities, licensed residential care, and certain home-health settings. Indiana law requires that only aides listed on INAR provide nursing or nursing-related services to residents in these facilities. The registry stores, for each aide:

• Full legal name and identifying information
• Certification number and status (active, expired, lapsed, revoked)
• Date of original certification and expiration date
• Training program and testing records
• Substantiated findings, if any (abuse, neglect, misappropriation)
• Employment history as reported by facilities

Indiana facilities are required to query INAR before hiring and before each renewal cycle. Hiring an aide who is not on INAR or who has a substantiated finding is an IDOH survey violation.

Initial Listing on INAR

A CNA is added to INAR after successfully completing:

1. An Indiana-approved 105-hour training program (see Section 1.4)
2. The Indiana CNA competency evaluation (written and skills) administered by Ivy Tech's CNA/QMA Central Testing Office

Once both are passed, the training program or the aide submits the documentation and IPLA/IDOH lists the aide on INAR. Initial certification is dated the date the competency evaluation was passed.

The 2-Year Renewal and the 8-Hour Work Rule

INAR certification is valid for 2 years. To renew, a CNA must demonstrate that they have worked at least 8 hours for pay performing nursing or nursing-related services during the 24 months preceding the renewal date. The work must be in a setting that the registry recognizes — typically a licensed health facility, home health under appropriate supervision, or certain assisted-living settings.

The 8-hour rule is a federal OBRA requirement that Indiana enforces. Its purpose is to ensure aides remain clinically active; an aide who has not practiced in 24 months is considered to have lost competency and must retrain and retest.

Renewal mechanics:

• The employer submits the renewal form verifying the 8-hour work history
• IPLA updates the expiration date to a new 2-year cycle
• If renewal is not processed by the expiration date, the certification lapses
• A lapsed CNA has a 120-day grace period to renew by documenting the 8 hours
• After 120 days, the CNA must retrain and retest to be re-listed

Substantiated Findings: Abuse, Neglect, Misappropriation

If IDOH investigates a complaint and substantiates that a CNA committed abuse, neglect, or misappropriation of resident property, the finding is entered on the aide's INAR record. Consequences:

• The finding is permanent on the registry record and is visible to any employer who queries INAR
• The aide is disqualified from employment in any Indiana licensed health facility
• The aide may request an administrative hearing to contest the finding
• Removal of a substantiated finding requires appeal or, in rare cases, a court order — it is not automatic

Abuse is the intentional infliction of physical or mental pain, injury, or intimidation. Neglect is the failure to provide goods or services necessary to avoid harm. Misappropriation is the deliberate misuse of a resident's property or funds. Each is defined in 410 IAC 16.2 and federal OBRA regulations.

Mandatory reporting of suspected abuse, neglect, or misappropriation is covered in Section 1.5.

Reciprocity for Out-of-State CNAs

Indiana recognizes the CNA credentials of other states through reciprocity (also called endorsement). An out-of-state CNA may be listed on INAR without retraining if all of the following are true:

1. The aide is currently listed and in good standing on the originating state's nurse aide registry
2. The originating state's training program was at least 105 hours (matching Indiana's requirement) — or the aide can document equivalent training
3. The aide passed a competency evaluation in the originating state
4. The aide has no substantiated finding of abuse, neglect, or misappropriation in any state
5. The aide has worked at least 8 hours for pay in nursing or nursing-related services in the past 24 months

If the originating state's training was fewer than 105 hours, the aide must complete additional Indiana training to reach the 105-hour minimum before reciprocity is granted. Aides with a substantiated finding in any state are not eligible for reciprocity in Indiana.

Common Status Situations

Practical Implications for the Exam and Practice

• The exam will test the 2-year renewal, the 8-hour work requirement, and what happens after a lapse
• Know that a substantiated finding is permanent and disqualifying — not a temporary suspension
• Reciprocity is a frequent test topic: remember the 105-hour training-equivalency rule and the clear-registry requirement
• An aide working with a lapsed certification — or a facility that hires one — is in violation; query INAR before each shift if there is any doubt