Becoming a Licensed Nursing Assistant in Rhode Island

Becoming a Licensed Nursing Assistant in Rhode Island

Rhode Island's rules live in 216-RICR-40-05-22, promulgated under R.I. Gen. Laws Chapter 23-17.9. Two features make Rhode Island different from most states:

1. It licenses nursing assistants individually — a license, not a registry listing — and no person may be employed as a nursing assistant in Rhode Island without one (§ 22.5(A)).
2. It requires 120 clock hours of training, well above the federal minimum of 75.

Step 1 — Eligibility

Step 2 — Complete a RIDOH-Approved Training Program

What the curriculum must cover (§ 22.12.2)

• Being a Nursing Assistant — the aide's function in institutions and in the home, working with the health care team, ethical responsibilities (accountability, confidentiality), policies and procedures, state rules and regulations related to the registration of nursing assistants, communication and interpersonal skills, infection control, safety and emergency procedures, promoting patients' independence, respecting patients' rights
• Basic Human Needs — physical, emotional, spiritual and mental health needs across the life cycle; modifying your behavior in response to the patient's behavior; developmental tasks; behavior management; maximum independence; working with the patient's family
• Caring for Patients — admission and discharge procedures; personal care skills; basic nursing skills including vital signs, environment, observing and reporting abnormal signs and symptoms, care when death is imminent, specimen collection, and the Heimlich maneuver; basic nutrition; fluid balance and intake and output
• Basic Restorative Services — body mechanics, anatomy and physiology, self-care training, assistive devices, range of motion, turning and positioning, bowel and bladder training, prosthetic and orthotic devices
• Care of Patients with Specific Problems — cognitive impairment and behavioral health conditions; and circulatory, respiratory, digestive, bowel and bladder, musculoskeletal, neurological, endocrine, and skin problems
• Patient's Rights — privacy and confidentiality, personal choice, grievances, resident and family groups, security of personal property, freedom from abuse, reporting abuse, and the use and avoidance of restraints

💡 Notice what is inside the curriculum. "State rules and regulations related to the registration of nursing assistants" is a required teaching topic in Rhode Island. The regulatory material in this chapter is not background reading — it is part of the required course of instruction.

Program competency testing

Separately from the NNAAP, the training program must test manual skills covering communication and interpersonal skills, infection control, safety and emergency procedures, promotion of independence, respecting patients' rights, basic nursing skills, mental health and social service needs, care of cognitively impaired patients, and basic restorative services. Where appropriate, skills must be demonstrated on a real patient or a "pseudo-patient," not on a mannequin (§ 22.7(J)(3)).

Step 3 — Application and Testing Are Filed by the Program

This is a Rhode Island quirk worth knowing. Under § 22.7(D)(3), the training program must:

• Prepare the paperwork and scheduling for the state examination
• Schedule testing with Credentia within 10 days after you complete the program
• File your nursing assistant license application with RIDOH within that same period
• Provide ongoing assistance to help you schedule and attend testing, and document that it did so

If your program goes quiet after graduation, that is a regulatory failure on their part. Call them.

Step 4 — The License Application

Submitted on RIDOH forms with:

1. Documented evidence of completion of a Department-approved training program
2. Documented evidence of successful completion of the required nursing assistant examination
3. The non-refundable processing fee — $35 (216-RICR-10-05-2)
4. A full BCI check from the Rhode Island Attorney General's Office

💰 Get your $35 back. Section 22.5.3(D)(1)(b)(4): if you are employed by a health care facility at the time of application and remain continuously employed by that same facility for six months after the license is issued, the facility must directly refund the fee to you. Combined with the rule that nursing homes must pay your NNAAP examination fees, an employed candidate's out-of-pocket cost can be close to zero.

Step 5 — The 120-Day Temporary Permit

This is the provision most often described incorrectly. The regulation (§ 22.5.4(D)) says:

Applicants for initial licensure as a nursing assistant by examination who have completed a nursing assistant training program in accordance with this Part may be issued a one hundred twenty (120) day Temporary Permit authorizing the applicant to work under direct supervision of a licensed nurse or physician until the applicant has passed all required portions of the examination.

Three things follow:

• It is a permit RIDOH issues, not an automatic grace period that starts on your first day of work.
• You must have completed training. Being merely enrolled does not qualify.
• The supervision is direct — the supervising nurse or physician must be and remain on the premises while you work (§ 22.3(A)(22)(a)).

RIDOH's cost-benefit analysis for this regulation notes that no extension beyond the 120-day grace period is allowed under either state or CMS rules. If you cannot test within four months of finishing training, you cannot keep working on the permit.

Step 6 — Licensure by Endorsement (Out-of-State CNAs)

Rhode Island offers two regulatory routes for someone already credentialed elsewhere (§ 22.5.3(A)):

Both routes still require the RIDOH application, the fee, and a full BCI check from the Rhode Island Attorney General's Office, and applicants must supply proof of the active license and employer attestation of the work experience. Request Interstate Verification from every state in which you have held a certification and start early — out-of-state processing is the usual bottleneck.

Step 7 — The Nursing Student Exemption

Under § 22.5.1(D), a person actively enrolled in an accredited BSN, ADN, or practical-nursing program who has completed two clinical courses including Fundamentals of Nursing, and who supplies written documentation from a clinical supervisor stating they are prepared to serve as a nursing assistant, is exempt from completing a Nursing Assistant Training Program and from sitting for the NNAAP Skills portion. Credentia lists this as eligibility route E-2, and such candidates take only the written examination.