1.1 Current South Carolina CNA Exam Facts

1.1 Current South Carolina CNA Exam Facts

Becoming a Certified Nurse Aide (CNA) in South Carolina opens the door to vital frontline roles in long-term care facilities, hospitals, assisted living communities, hospice agencies, and home health care. In South Carolina, the nurse aide certification process is overseen by the South Carolina Department of Health and Human Services (SCDHHS). To ensure that all practicing aides meet rigorous federal and state competency standards, SCDHHS contracts with Credentia to manage test development, scheduling, administration, scoring, and registry maintenance through the National Nurse Aide Assessment Program (NNAAP).

Earning your credential requires passing two distinct, rigorous components: a cognitive Written (or Oral) Examination and a hands-on Clinical Skills Evaluation. Understanding the examination architecture, scoring parameters, scheduling workflows, and testing rules is your first step toward achieving certification on your very first attempt.

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Candidate Eligibility & Testing Pathways

Before registering for the South Carolina Nurse Aide Exam, candidates must qualify under one of several state-recognized eligibility routes established by SCDHHS:

1. E1 — South Carolina State-Approved Trained Candidate: You successfully completed a South Carolina state-approved nurse aide training program within the last 24 months. All new candidates must have completed a 100-hour program that includes 40 hours of clinical training.
2. E2 — Out-of-State Trained Candidate: You completed a 100-hour state-approved nurse aide training program in another state within the last 24 months. You must upload a completion certificate, diploma, or letter on state or training-program letterhead that states the number of classroom AND clinical hours.
3. E3 — Lapsed or Expired South Carolina Registry Applicant: You completed a 100-hour South Carolina state-approved program and your certificate has not been expired for more than 24 months. The certificate must be in good standing.
4. E4 — Out-of-State Registry Applicant: You completed a 100-hour state-approved program with clinical included in another state, and your certificate has not been expired for more than 24 months and is in good standing. Documentation of classroom and clinical hours must be uploaded.
5. E5 — Student Nurse, LPN or RN Graduate, or Military Candidate: You must contact SCDHHS at scnar@scdhhs.gov to have your eligibility determined before submitting an application. Credentia cannot approve this route on its own.

Route trap to memorize: nursing students, RN/LPN graduates, and military candidates are not separate numbered routes in South Carolina — they are combined into the single route E5, and E5 is the only route requiring SCDHHS pre-approval. Routes E2, E4, and E5 all require uploaded supporting documents; E1 and E3 do not.

If an original letter is submitted as proof of training, it must be on the training program's letterhead and must contain four items: (1) the candidate's name, (2) the training program completion date, (3) the training program code number, and (4) the signature of the instructor, director, or administrator.

Candidates who are employed as nurse aides — or who hold a written offer of employment from a Medicare/Medicaid-certified nursing home — must be sponsored by that nursing home. Separately, anyone on restricted activity or light duty for medical reasons may take the written/oral exam but is prohibited from taking the Skills Evaluation until medical documentation confirms return to full, unrestricted duty.

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Structure of the Written Examination

The written examination can be taken two ways in South Carolina: at a Credentia test site (regional test sites and approved in-facility sites), or online as a remote-proctored exam scheduled through CNA365. At a test site the exam is still delivered on paper — you fill in ovals on a separate answer sheet, and Credentia warns that markings in the test booklet will NOT be accepted as answers. That is why the required supply list includes three sharpened No. 2 pencils and an eraser.

The 10 Pretest Questions

Candidates often wonder why the exam contains 70 questions when only 60 are scored. The 10 pretest questions are newly developed test items undergoing statistical evaluation. They are indistinguishable from scored questions and are dispersed randomly throughout the test. Pretest items do not affect your final score, but because you cannot identify which items are pretest questions, you must treat every question with equal diligence.

Pass/Fail Scoring Philosophy

SCDHHS and Credentia do not publish a numerical percentage cutoff (such as 75% or 80%) for the written examination. The NNAAP examination uses a criterion-referenced standard, and each test form is statistically equated so that a slightly harder or easier form does not change the standard a candidate must meet. Your score report reports the outcome, not a public percentage. Ignore any prep site that quotes a specific written passing percentage as an official South Carolina figure — that number is not published by the exam owner.

The 2024 NNAAP content outline is based on the 2019–2020 Job Analysis and Knowledge, Skill, and Ability Study of Nurse Aides published by the National Council of State Boards of Nursing (NCSBN) in 2023. The outline took effect in October 2024, and the NNAAP exam is now developed and managed by Credentia Nurse Aide LLC rather than NCSBN.

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The Oral Examination Option

For candidates who experience difficulty reading English or have documented reading comprehension limitations, Credentia provides an Oral Examination format as an alternative to the standard written test.

Oral Exam Mechanics

• Delivery: At a test site the Oral Examination is delivered as a recording that you listen to while following along in the test booklet; answers still go on the separate answer sheet. If you take the online proctored version, you must supply your own wired headset.
• Two-Part Structure — you must pass both parts:
  • Part 1 (60 multiple-choice questions): General nurse aide knowledge. Each question is read aloud twice. There is no unlimited replay button — plan to make your selection on the second reading.
  • Part 2 (10 word-recognition items): These test whether you know common words used in long-term care facilities. Each word is read three times, and you match the word you hear to the written word on your answer sheet.
• Both parts must be passed. Passing Part 1 but failing Part 2 means you have not passed the Oral Examination.

Important Note: You must request the Oral Examination when you fill out your application. You cannot switch from a written to an oral format on test day.

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Clinical Skills Evaluation Structure

The Clinical Skills Evaluation is a hands-on practical exam conducted in a simulated long-term care setting. A Nurse Aide Evaluator observes and rates your performance across 5 distinct clinical skills within a 30-minute testing window. Arrive 30 minutes early; skills test times are approximate, so plan to spend the day.

+-------------------------------------------------------------------------+
|                    5 CLINICAL SKILLS EVALUATION (30 MIN)                |
+-------------------------------------------------------------------------+
|  ALWAYS: Hand Hygiene (Hand Washing) - every candidate, every time      |
|  ALWAYS: One Measurement Skill                                          |
|    (Electronic BP, Radial Pulse, Respirations, Urine Output, Weight)    |
|  PLUS: Three skills drawn at random from the remaining 16 skills        |
+-------------------------------------------------------------------------+

1. Hand Hygiene (always included): Washing hands with soap and running water is mandatory for every single candidate. It is scored as one of your five skills, not as a freebie.
2. One measurement skill (always included): Every candidate performs exactly one skill that requires recording numerical clinical data — blood pressure, radial pulse, respirations, urinary output, or weight. You record the value on a Recording Sheet for Measurement Skills in a box labeled Candidate Results.
3. Three randomly selected skills: Credentia's skills listing contains 23 numbered skills, but Skill 23 (Measures and Records Manual Blood Pressure) is flagged "THIS SKILL IS NOT TESTED" in South Carolina — the state tests Skill 12, Measures and Records Electronic Blood Pressure, instead. That leaves 22 testable skills: hand hygiene, five measurement skills, and 16 remaining skills covering personal care, mobility and transfers, positioning, range of motion, elimination, and PPE, from which your three random skills are drawn.

To pass the Skills Evaluation you must earn a Satisfactory result on all five (5) of five skills. Any skill scored Unsatisfactory is a failed skill and fails the whole evaluation. Within each skill you must perform every bold Critical Element Step correctly and meet that skill's passing standard (cut score) on the remaining steps — performing only the critical element correctly does not automatically pass the skill.

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South Carolina CNA Examination Fee Breakdown

All exam fees in South Carolina must be paid during online registration through the Credentia CNA365 electronic portal. Fees are non-refundable once scheduled.

South Carolina's published fee schedule has been in effect since July 1, 2020:

Who pays matters. Under federal and South Carolina law, candidates employed as nurse aides in Medicaid/Medicare-participating nursing homes are prohibited from paying their own examination fees — the employer must pay the examination fee and any retest fee. The same rule covers candidates who have a written commitment or signed acceptance of employment on file with such a facility. In practice the candidate pays online with a credit card or single-use prepaid card and is then reimbursed by the employer. Candidates who are not employed as nurse aides in those facilities may pay their own fee.

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Scheduling & Registration via Credentia CNA365

South Carolina utilizes the Credentia CNA365 online platform for all candidate administration:

1. Program Approval & Roster Submission: Upon completing your 100-hour training program, your training provider uploads your graduation verification directly into CNA365.
2. Candidate Account Creation: You will receive an automated email invitation to activate your CNA365 profile. Ensure that your legal name matches your government-issued identification cards exactly—including middle names, hyphens, and suffixes.
3. Application & Payment: Complete the online application, upload any required prerequisite documentation (such as training certificates or approval letters), select your exam format (written or oral), and submit payment via credit card, debit card, or prepaid voucher.
4. Selecting Test Date & Location: You may choose from regional testing centers across South Carolina (e.g., Columbia, Charleston, Greenville, Florence, Rock Hill) or test at your own training facility if approved as an In-Facility Test Site (INF).
5. Confirmation: Your scheduling confirmation gives you the report time and test site. Arrive 30 minutes before your scheduled time for both the written examination and the skills evaluation. If you are late for the written examination you will not be allowed to test and your fee will not be refunded.

If you are late or absent, you may call Credentia at 1-888-204-6249 within 14 days of the exam date to request an excused absence for one of six reasons: illness of yourself or an immediate family member, a death in the family, a disabling traffic accident, a court appearance or jury duty, military duty, or a weather emergency. You must supply documentation (for example a court notice or a provider's verification), a case number is assigned, and resolution takes roughly 3–5 business days. Candidates who are absent or late without changing or canceling under the Change/Cancel Policy forfeit the exam fee, and Credentia's decision on an excused absence is final.

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Test-Day Rules, Identification & Attire

Strict administrative rules govern test-day admissions. Candidates who arrive late or lack proper identification will be turned away with fee forfeiture.

Mandatory Identification Requirements

You must bring two (2) forms of official, signature-bearing identification, and one of the two must be a photo ID. Photocopies are never accepted.

• Primary ID (photo and signature): government-issued driver's license, U.S. Department of State driver's license, U.S. learner's permit (plastic card with photo and signature), national/state/country ID card, passport, passport card, military ID, or military ID for spouses and dependents.
• Secondary ID (signature, not expired): U.S. Social Security card, debit (ATM) or credit card, state-issued identification card, a current federal employment authorization document (EAD) photo card, or any form of ID from the primary list.
• Name Matching: the name on your ID must be the same as the name you used on your application. If your name has changed, you MUST bring proof of the change (for example a marriage license or divorce decree) to the test center.

What You Must Bring (Credentia's Required List)

Credentia's list is short and absolute — "no other materials will be allowed":

• Two (2) forms of proper identification
• Three (3) sharpened No. 2 pencils
• An eraser
• Your Social Security number (know it; you are not bringing the card as your only ID)
• A watch with a second hand
• Non-skid footwear

Dress Requirements for the Skills Evaluation

Credentia's dress rule is written for clinical access, not for a uniform look. You must wear:

• Flat, slip-on, non-skid shoes.
• A loose-fitting top with short sleeves that can be rolled up to the shoulder, or a tank top.
• Loose-fitting pants that can be rolled up.
• You will be required to put a gown on over your clothing, and in no case may you remove clothing down to undergarments.

Scrubs are common but are not the published requirement — what matters is that the evaluator can see you expose an arm to the shoulder and a lower leg. Tell the evaluator before the exam begins about any food or latex allergy, any sensitivity to skin soaps or lotion, and any range-of-motion limitation. Do not come to the test site with open areas or sores on your skin; reschedule until the skin has fully healed.

Cell phones, beepers, and other electronic devices must be turned off and are not permitted during testing, and there is no storage for personal belongings at test sites. No guests, visitors, pets, or children are allowed at the test site.

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Retake Rules: The Three-Attempt & Two-Year Policy

South Carolina strictly enforces the Three-Attempt / Two-Year Rule for nurse aide certification:

Credentia states the rule for South Carolina in one sentence: you must pass both portions of the exam within two (2) years from your training completion date OR within three (3) attempts, whichever comes first.

• "Whichever comes first" is the trap. The limit is not "three tries at the written plus three tries at the skills, as long as you are inside two years." Whichever boundary you hit first ends your eligibility on that training.
• Passing one part sticks. If you pass the written exam and fail the skills evaluation, you retake only the skills evaluation ($95) — you do not repeat the written exam. But those retakes still count against the same window.
• 24-month clock starts at training completion, not at your first test date.
• Mandatory retraining trigger: if you do not pass both parts inside that window, you must complete an entire 100-hour state-approved Nurse Aide Training Program again and retest both portions. South Carolina applies this same policy to RN and LPN students who tested under route E5.