Your 2025 Guide to Becoming a Nursing Assistant-Certified (NAC/NA-C) in Washington State: Top Programs, Requirements, Exam & Salary Insights

Quick Summary: Eager to launch a rewarding healthcare career in the Evergreen State? Becoming a Nursing Assistant-Certified (NAC or NA-C) in Washington offers a direct pathway to making a vital impact on patient well-being. This all-inclusive guide details every crucial step: understanding Washington's specific certification requirements set by the Department of Health (DOH), locating DOH-approved Nursing Assistant Training Programs (NATPs), mastering the National Nurse Aide Assessment Program (NNAAP®) Examination administered by Credentia, and exploring salary expectations across Washington. We've included insights on criminal background checks (including WA State Patrol WATCH and DSHS checks), financial aid information, essential tips for career advancement, and how to maintain your active NAC certification, including continuing education (CE) requirements. Whether you're new to healthcare or seeking a meaningful career change, this resource is your blueprint for a successful NAC career in Washington.

Introduction: Your Path to Becoming a Nursing Assistant-Certified in Washington

Welcome to your definitive guide to becoming a Nursing Assistant-Certified (NAC or NA-C) in Washington State! If you aspire to a hands-on healthcare role where you provide essential, compassionate care, this is an excellent place to start. This guide is specifically tailored for individuals in Washington, outlining the steps to certification as mandated by the Washington State Department of Health (DOH). We'll navigate everything from understanding the NAC's role and meeting state requirements, to finding an approved training program, preparing for the state competency exam administered by Credentia, and exploring career opportunities across the Evergreen State. Let's embark on your journey.

1. What is a Nursing Assistant-Certified (NAC/NA-C) in Washington?

In Washington State, a Nursing Assistant-Certified (NAC or NA-C) is a crucial healthcare professional who delivers fundamental hands-on care to patients and residents in a variety of settings. NACs work under the direct supervision of licensed nursing staff, such as Registered Nurses (RNs) and Licensed Practical Nurses (LPNs). Their primary role is to assist individuals with their basic daily living needs, ensuring their comfort, safety, and dignity. Key responsibilities typically include:

• Assisting with Activities of Daily Living (ADLs): bathing, dressing, grooming, toileting, and feeding.
• Taking and accurately recording vital signs (temperature, pulse, respiration, blood pressure).
• Helping with mobility: transferring individuals, assisting with walking, and repositioning to prevent complications like pressure sores.
• Observing patients' conditions and reporting any significant changes to the supervising nurse promptly.
• Providing emotional support, companionship, and actively promoting patient/resident rights.
• Maintaining a clean, safe, and organized environment for patients/residents.
• Following infection control procedures diligently.

The NAC role in Washington demands physical stamina, empathy, strong communication skills, and meticulous attention to detail. It offers a deeply rewarding experience and serves as a solid foundation for those wishing to advance their careers in nursing or other healthcare fields. It's important to note that Washington also has a separate certification for Home Care Aides (HCAs), which has different training and testing requirements, primarily for in-home care settings not under nursing supervision. This guide focuses on the NAC certification.

2. Job Outlook & Demand for NACs in Washington

The demand for Nursing Assistants-Certified in Washington is consistently robust and expected to grow. This is largely due to Washington's significant aging population, leading to increased needs in long-term care facilities (nursing homes), hospitals, assisted living facilities, and adult family homes. The U.S. Bureau of Labor Statistics (BLS) projects sustained national growth for nursing assistants, and Washington, with its extensive healthcare infrastructure, reflects this trend.

WorkSource Washington, the state's workforce development system, often identifies Nursing Assistants as an in-demand occupation. Openings arise frequently due to new job creation and the need to replace workers who retire or transition to other roles.

3. Understanding Local NAC Demand Across Washington

NAC job opportunities are abundant throughout Washington, with varying concentrations by region:

• Puget Sound Region (Seattle, Tacoma, Bellevue, Everett): King, Pierce, and Snohomish counties have the highest concentration of hospitals, large skilled nursing facilities (SNFs), and assisted living communities, resulting in significant demand for NACs.
• Southwest Washington (Vancouver area): Proximity to Portland, OR, and its own growing healthcare sector create strong demand.
• Eastern Washington (Spokane, Tri-Cities): Spokane serves as a major healthcare hub for Eastern Washington and parts of Idaho, with consistent demand. The Tri-Cities area (Kennewick, Pasco, Richland) also has a notable healthcare presence.
• Olympic Peninsula & Coastal Regions: While less densely populated, these areas have a steady need for NACs in local hospitals, nursing homes, and community health settings.
• Central Washington & Rural Areas: Similar to other rural areas, there's a critical and often unmet need for NACs in smaller healthcare facilities.

Exploring job boards like WorkSourceWA.com, major healthcare system career pages, and connecting with local DOH-approved training programs can offer more specific insights into regional demand.

4. NAC Salary & Benefits in Washington

Average Compensation

Salaries for NACs in Washington are generally higher than the national average, reflecting the state's higher cost of living and demand. According to the U.S. Bureau of Labor Statistics (BLS) for May 2023, Nursing Assistants in Washington earned a mean hourly wage of $22.70, translating to an average annual salary of approximately $47,220.

Wages can vary based on location within WA (e.g., higher in the Seattle metro area compared to some rural parts), years of experience, type of facility (hospitals and unionized settings often offer higher pay), and additional certifications or endorsements. Entry-level NAC positions might start in the $18-$21/hour range, while experienced NACs or those in high-demand settings or with union representation can earn significantly more.

Pay by Setting (Typical Washington Estimates for NAC)

Setting	Average Hourly Wage Range (WA)
Hospitals (often unionized)	$21.00 – $30.00+
Skilled Nursing Facilities (SNFs) / Long-Term Care	$20.00 – $27.00
Assisted Living Facilities / Adult Family Homes	$19.00 – $25.00
Home Health Agencies (NAC role, distinct from HCA)	$19.50 – $26.00 (plus potential mileage reimbursement)

Note: These are general estimates. Always research specific regions and employers. Union contracts (e.g., SEIU 1199NW, UFCW 3000) significantly influence wages and benefits in many Washington facilities.

Shift Differentials & Overtime

Many Washington healthcare facilities offer shift differentials (e.g., an extra $1.50-$5.00/hour) for evening, night, weekend, or holiday shifts. Overtime pay (typically 1.5 times the regular rate for hours worked over 40 in a week, or as defined by union contracts) can also substantially increase earnings.

Common Benefits Packages

Full-time NACs in Washington, particularly in larger institutions or unionized environments, often receive comprehensive benefits packages, which may include:

• Health, dental, and vision insurance (often with good employer contributions)
• Retirement plans (e.g., 401(k), pension plans like PERS for public employees)
• Paid time off (vacation, sick leave, personal days, holidays)
• Tuition reimbursement programs for career advancement
• Life insurance and short/long-term disability coverage
• Union representation benefits in many facilities

5. Washington NAC Certification Requirements (DOH)

To become a Nursing Assistant-Certified (NAC or NA-C) in Washington State and be listed on the Washington Nurse Aide Registry, you must meet specific requirements set by the Washington State Department of Health (DOH), Nursing Care Quality Assurance Commission:

• Age & Education: You must be at least 18 years old to be certified. While a high school diploma or GED is not explicitly required by DOH for certification, it is generally required or preferred by most training programs and employers. You must be able to read, write, and speak English proficiently.
• Complete a DOH-Approved Training Program: You must successfully complete a state-approved Nursing Assistant Training Program (NATP). This program must consist of a minimum of 85 clock hours, which includes:
  • A minimum of 35 hours of classroom instruction.
  • A minimum of 10 hours of lab practice (skills lab).
  • A minimum of 40 hours of supervised clinical training in an approved healthcare setting (typically a nursing home).
• Pass the Competency Examination: After completing training, you must pass both parts of the National Nurse Aide Assessment Program (NNAAP®) Examination. This exam is administered in Washington by Credentia. It includes a Written (or Oral) examination and a Skills Evaluation.
• Criminal History Background Check: Washington law mandates criminal history background checks for individuals working with vulnerable populations.
  • For employment in DSHS (Department of Social and Health Services) licensed facilities (like nursing homes, assisted living, adult family homes), you must undergo a DSHS background check through the Background Check Central Unit (BCCU), which includes fingerprinting.
  • Training programs will likely require a Washington State Patrol (WSP) WATCH (Washington Access To Criminal History) check and potentially a DSHS check for clinical placements.
  • The DOH itself requires applicants to answer attestation questions about criminal history, and certain convictions can disqualify an individual from certification or result in disciplinary action.
• Health Screening: You must have a health examination, including a TB test (PPD skin test, chest X-ray if indicated, or IGRA blood test), verifying you are in good health, free from communicable diseases, and can perform NAC duties. This is usually required before starting clinical training. Proof of certain immunizations (e.g., MMR, Varicella, Hepatitis B series or declination, annual Flu shot, COVID-19 vaccine per facility policy) may also be required by training programs and facilities.
• Application for Certification: After passing the exam, you must apply to the DOH for certification. This involves submitting an application packet, paying a fee, and undergoing the necessary background check processes.

Alternative pathways to exam eligibility exist (e.g., certain nursing students, out-of-state NACs seeking reciprocity, military medical training), but completing a Washington NATP is the most common route.

Always verify the most current requirements with the Washington State DOH Nursing Assistant Certified page and your chosen DOH-approved training program.

6. Finding DOH-Approved Nursing Assistant Training Programs (NATPs) in WA

It is crucial to select a Nursing Assistant Training Program (NATP) that is approved by the Washington State Department of Health (DOH) and the Nursing Care Quality Assurance Commission. Only graduates of these approved programs are eligible to take the state competency exam and apply for certification. The DOH website provides a list of approved programs. Common providers in Washington include:

• Washington Community and Technical Colleges: Many community and technical colleges across WA offer excellent, DOH-approved NATPs. These are often eligible for state financial aid.
• Private Career Schools & Vocational Institutes: Numerous private career colleges and technical institutes in Washington offer Nursing Assistant training. Ensure they are DOH-approved and licensed by the Workforce Training and Education Coordinating Board (WTECB) if applicable.
• Long-Term Care Facilities (Nursing Homes): Some nursing homes offer their own DOH-approved NATPs. These may be free if you commit to working for the facility, as federal law prohibits approved nursing homes from charging for training provided to their prospective or current employees if they work for them.
• High Schools with Health Science Programs: Some Washington high schools offer Nursing Assistant training as part of their Career and Technical Education (CTE) pathways.
• American Red Cross: Some Red Cross chapters in Washington may offer DOH-approved Nursing Assistant training.

When choosing a program in Washington, consider:

• DOH Approval: This is mandatory. Verify on the DOH website's list of approved training programs.
• Cost & Financial Aid: Inquire about tuition, fees (for background checks/fingerprinting, books, uniform, physical exam, state exam fee – Credentia's fee, DOH application fee), and available aid (Worker Retraining, Opportunity Grant, BFET, WIOA funding through WorkSource Washington, scholarships, payment plans).
• Schedule & Duration: Programs range from intensive full-time (e.g., 4-7 weeks for an 85-hour program) to part-time evening/weekend options.
• Location & Clinical Sites: Factor in commute times for both classroom and clinical portions.
• State Exam Pass Rates: Ask the program about their graduates' success on the Credentia NNAAP® Examination.
• Job Placement Assistance: Some programs offer help with resume writing, interview skills, and connecting with local employers.
• Criminal Background Check Process: Understand how the program facilitates the required background checks for clinicals and advises on DOH/DSHS requirements.

You can find a list of approved programs on the DOH Nursing Assistant Training Programs page (Note: link may change, navigate from the main NAC page if needed).

7. What to Expect from Your Washington NAC Program Structure & Duration

All Washington State Department of Health (DOH)-approved Nursing Assistant Training Programs (NATPs) must provide a minimum of 85 total clock hours of instruction and training. This is typically structured as follows:

• Classroom (Didactic) Instruction (minimum 35 hours): This portion covers theoretical knowledge.
• Laboratory Practice (Skills Lab) (minimum 10 hours): Hands-on skills practice in a simulated lab environment.
• Supervised Clinical Training (minimum 40 hours): This hands-on portion must be conducted in a DOH-approved clinical setting, predominantly a licensed nursing home. Students apply their learned skills providing direct care to residents under the close supervision of a DOH-approved instructor (typically an RN with specific qualifications). Topics generally include:
  • Introduction to the role of the NAC, healthcare settings, ethics, patient rights, and legal responsibilities.
  • Communication and interpersonal skills with patients, families, and healthcare team members.
  • Infection prevention and control, safety measures, and emergency procedures.
  • Basic human anatomy, physiology, and common health conditions.
  • Personal care skills (hygiene, grooming, bathing, dressing, elimination needs).
  • Nutrition, hydration, and assisting with feeding.
  • Vital signs measurement (temperature, pulse, respiration, blood pressure) and observation skills.
  • Care of residents with cognitive impairments (e.g., Alzheimer's, dementia), mental health, and social service needs.
  • Restorative care, promoting independence, and preventing complications of immobility.
  • Basic emergency care and CPR (often included or required as a co-requisite).
  A specified portion of classroom and lab instruction must be completed before students can participate in direct resident care during clinicals. All required background checks must also be cleared.

Program Duration (for an 85-hour program):

• Full-Time Programs: Can often be completed in as little as 3-5 weeks, depending on the daily schedule intensity.
• Part-Time Programs (Evenings/Weekends): May take 6-10 weeks or longer to complete.

Regardless of the format, all approved programs are designed to prepare students thoroughly for the Washington NNAAP® Examination (Credentia) and for competent, compassionate practice as an NAC.

8. The Washington NNAAP® Examination (Credentia): What You Need to Know

After successfully completing your DOH-approved NATP, you must pass the National Nurse Aide Assessment Program (NNAAP®) Examination to be eligible to apply for certification. This exam is administered in Washington by Credentia. The exam consists of two parts, both of which must be passed:

1. Written Examination (or Oral Examination option)

• Consists of 70 multiple-choice questions (60 scored questions and 10 non-scored pretest questions).
• Tests your knowledge on topics covered in your training program, categorized into areas like Physical Care Skills, Psychosocial Care Skills, and Role of the Nurse Aide.
• You will have two hours (120 minutes) to complete this examination.
• An oral version (audio recording of the questions via headphones) is available in English if requested in advance during the application process. This also consists of 70 multiple-choice questions and has a two-hour time limit.

2. Skills Evaluation

• You will be asked to perform five randomly selected nursing assistant skills.
• One of the skills will always be Hand Hygiene (Hand Washing). Another skill will involve recording a measurement (e.g., blood pressure, radial pulse, urinary output, weight).
• A Nurse Aide Evaluator (NAE) will observe and score your performance based on critical steps for each skill. You must perform all critical steps correctly and achieve a satisfactory overall score on each skill to pass.
• You will have a specific time limit (check the Credentia Washington Nurse Aide Candidate Handbook, typically around 25-35 minutes depending on the skills assigned) to complete all five skills.

Attempts & Retakes: In Washington, you generally have up to three attempts to pass both parts of the exam within 12 months (one year) of completing your training program. If you fail one part, you only need to retake that part. If you do not pass both parts within the three attempts or the one-year timeframe, you must complete another DOH-approved NATP.

On Exam Day: Arrive on time (usually 30 minutes prior to your scheduled exam). You MUST bring two forms of current, valid (not expired), signature-bearing identification. One ID must be a U.S. government-issued photo ID (e.g., driver's license, state ID, passport). The second ID must also be signed. Both names must match exactly what was submitted on your application. Wear appropriate attire (flat, non-skid, closed-toe shoes; scrubs are often recommended/required) and a watch with a second hand.

Always refer to the latest Washington Nurse Aide Candidate Handbook available on the Credentia website for the most current exam policies, procedures, skill lists, fees, and testing site information.

9. Getting Certified and Listed on the WA Nurse Aide Registry

Initial Certification and Registry Listing

After successfully passing both the Written (or Oral) Examination and the Skills Evaluation administered by Credentia, you must then apply to the Washington State Department of Health (DOH) for your NAC certification. Passing the exam alone does not grant certification. The application process involves:

• Submitting a completed Nursing Assistant-Certified application packet to the DOH.
• Paying the required application fee to the DOH.
• Successfully completing the required criminal background checks (DOH attestation, and employer-initiated DSHS/WSP checks).
• Providing proof of completing a DOH-approved NATP and passing the NNAAP® exam.

Once your application is approved and all requirements are met, the DOH will issue your NAC certification and list you on the official Washington Nurse Aide Registry (accessible via the DOH Provider Credential Search). Employers are required by law to verify your active certification status.

Maintaining Your Active Certification: Renewal

Your NAC certification in Washington is valid for one year and must be renewed annually before your birthday.

• Work Requirement: You must have worked for monetary compensation as an NAC, performing nursing tasks under the supervision of a licensed nurse, for at least eight (8) hours within your current certification period (the past year).
• Continuing Education (CE): You must complete 12 hours of DOH-approved continuing education each year prior to renewal.
• Renewal Process: The DOH will typically mail a renewal notice to your address on record prior to your certification expiration. You are responsible for renewing your certification online via the DOH SecureAccess Washington portal or by mail. This involves attesting to meeting the work and CE requirements and paying the renewal fee. Keep records of your employment and CE completion.

If you do not meet the work and CE requirements, your certification will expire. To reinstate an expired NAC certification, requirements vary based on how long it has been expired and may involve retaking the NNAAP® exam and/or completing another NATP.

Out-of-State NACs: Reciprocity/Endorsement

If you are a Nursing Assistant certified in another state and your certification is active and in good standing (no findings of abuse, neglect, or misappropriation of property), you can apply for Washington NAC certification through "reciprocity" (also known as endorsement). You'll need to complete the NAC application, provide verification from your original state(s) of certification, meet Washington's training hour and CE requirements (or show equivalent), and pass the NNAAP® exam if you haven't taken it or if your training hours are insufficient. You will also need to undergo Washington's background check process.

10. Real Stories: NAC Journeys in Washington

David's Start in Seattle

David, looking for a career change in Seattle, enrolled in a DOH-approved NATP at a local community college, utilizing the Worker Retraining grant. "The program was intensive, especially the clinicals in a busy King County nursing home, but the instructors were dedicated," he says. After passing his Credentia exams and applying to DOH, David was hired by a major hospital in Seattle and appreciates the union benefits and opportunities.

Sophia's Path in Spokane

Sophia, a recent high school graduate from Spokane, wanted direct patient care experience before considering nursing school. She attended an NATP offered by a private training institute. "Practicing the NNAAP skills over and over with classmates was key. The background check process was thorough but manageable," Sophia notes. She now works at an assisted living facility in Spokane County and is saving up for LPN school.

Liam's Opportunity in Rural Eastern Washington

Liam, from a small agricultural town, saw NAC certification as a way to find stable employment locally. He found an NATP offered part-time through a regional healthcare provider. "There's a real need for caregivers here. The program was accessible, and I got a job offer before I even finished my clinicals," he shares. After certification, he began working at the local nursing home.

11. A Day in the Life of a Washington NAC

A typical day for an NAC in Washington, whether in a bustling Puget Sound hospital, a long-term care facility in Yakima, or an adult family home in Bellingham, is dynamic and patient-focused:

• Beginning of Shift:
  • Clock in, attend report/huddle to receive assignments, updates on patient/resident conditions, and specific care instructions from the outgoing shift or charge nurse.
  • Gather necessary supplies (linens, personal care items, etc.) for assigned individuals.
  • Make initial rounds to greet individuals, assess immediate needs, and ensure safety.
• Morning/Daytime Routine (can vary by shift):
  • Assist with Activities of Daily Living (ADLs): helping residents with bathing, dressing, oral hygiene, grooming, and toileting, always ensuring privacy, dignity, and promoting as much independence as possible.
  • Serve meal trays, assist with feeding if necessary, encourage fluid intake, and accurately record food and fluid intake/output as per facility policy.
  • Take and record vital signs (temperature, pulse, respirations, blood pressure, pain assessment) as scheduled or directed by the care plan or nurse.
  • Change bed linens, tidy rooms, and maintain a clean and safe environment (e.g., ensuring call bell is within reach, bed in low/locked position, pathways clear).
  • Assist with mobility: ambulation (walking with or without assistive devices), transfers (e.g., bed to chair, using a gait belt or mechanical lift per training), range-of-motion exercises, and frequent repositioning to prevent skin breakdown and contractures.
• Throughout the Shift:
  • Respond promptly and courteously to call lights and individual requests for assistance.
  • Carefully observe individuals for any changes in condition (physical, mental, emotional, behavioral) and report these observations immediately and accurately to the supervising licensed nurse.
  • Provide emotional support, active listening, and engage in appropriate social interaction, recognizing cultural diversity.
  • Accurately and timely document all care provided, observations, and any incidents according to facility policy and state/federal regulations. This is often done via Electronic Health Records (EHR).
  • Adhere strictly to infection control protocols (e.g., proper handwashing, use of Personal Protective Equipment - PPE as required).
• End of Shift:
  • Ensure individuals are comfortable, safe, and their immediate needs are addressed before the next shift arrives.
  • Complete all charting thoroughly and accurately.
  • Provide a comprehensive, factual, and organized report to the oncoming NAC/shift or charge nurse.

Washington NACs are vital members of the healthcare team, requiring diligence, keen observational skills, excellent communication, cultural sensitivity, and a strong commitment to person-centered care.

12. Frequently Asked Questions (FAQs) for Aspiring Washington NACs

Is a criminal background check mandatory to become an NAC in Washington?

Yes. Applicants for NAC certification must answer criminal history questions on their Department of Health (DOH) application. Additionally, employers—especially DSHS-licensed facilities—are required to conduct DSHS background checks (including fingerprinting) and Washington State Patrol (WSP) WATCH checks. Certain convictions can prevent certification or employment.

Are Continuing Education Units (CEUs) required to renew my Washington NAC certification?

Yes. Washington State requires Nursing Assistants-Certified (NACs) to complete 12 hours of DOH-approved continuing education each year, in addition to meeting the 8-hour work requirement, to be eligible for certification renewal.

Can I work as an NAC in Washington while waiting for my exam results or DOH certification?

After completing a DOH-approved Nurse Aide Training Program (NATP), you may work as a “Nursing Assistant-Registered” (NAR) for up to 120 days from your date of hire in a nursing home while pursuing certification. You cannot identify or work as a Certified Nursing Assistant (NAC) until your DOH certification is issued and active. Employment remains contingent on clearing required background checks.

What if my Washington NAC certification expires?

If your certification expires, you cannot work as an NAC. To reinstate, you must meet DOH requirements based on how long your certification has been expired. This may include completing additional continuing education, retaking the NNAAP® exam, and potentially completing another NATP. Contact the DOH for specific guidance.

How do I transfer my out-of-state CNA certification to Washington (reciprocity)?

Apply for reciprocity with the DOH by submitting the NAC application, verification of your active, good-standing out-of-state certification, and proof of meeting Washington’s training hour and continuing education requirements (or equivalency). You may need to pass the NNAAP® exam if your original state’s requirements differ significantly. Washington’s background check requirements must also be met.

13. Tips for Success in Your NAC Training and Career in WA

• Master the NNAAP® Skills: Washington uses the NNAAP® exam via Credentia. Practice every skill meticulously according to the official Credentia Washington Candidate Handbook's skills checklist, focusing on all critical steps.
• Navigate Background Checks Proactively: Understand the WSP WATCH and DSHS BCCU background check processes. Be prepared for fingerprinting and provide accurate information.
• Complete All 85 Training Hours: DOH-approved programs have strict attendance policies. Be present, punctual, and engaged in all classroom, lab, and clinical components.
• Track Your CEs for Renewal: Start tracking your 12 annual DOH-approved CEs early to ensure timely renewal. Keep certificates of completion.
• Professionalism is Key: Maintain a professional demeanor, appropriate attire (especially non-skid, closed-toe shoes), respectful communication, and a consistently positive and empathetic attitude.
• Document for Renewal: Keep accurate records of your employment hours and CE completion for your annual DOH renewal. Keep your contact information with DOH current.
• Stay Informed: Periodically check the DOH Nursing Assistant and Credentia (WA) websites for any updates to regulations, forms, or procedures.

14. Advancing Your Career: Paths Beyond NAC in Washington

Your Washington NAC certification is an excellent launching pad. Many NACs in WA advance to other rewarding healthcare roles:

• Medication Assistant - Certified (MA-C): NACs with specific experience and additional DOH-approved training (around 100 hours) and passing a state exam can become MA-Cs, allowing them to administer certain medications in nursing homes under RN/LPN supervision.
• Licensed Practical Nurse (LPN): A very common next step. LPN programs in Washington typically take 12-18 months. The Washington State Nursing Care Quality Assurance Commission (part of DOH) regulates LPNs.
• Registered Nurse (RN): Pursue an Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) from a DOH-approved program. Many WA community colleges and universities offer these programs.
• Home Care Aide (HCA): While a separate initial certification, some NACs may also obtain HCA certification (requiring 75 hours of DOH-approved training and exam) if they wish to work in DSHS-contracted in-home care settings. Some NAC training may provide equivalency for parts of HCA training.
• Specialized Roles: With experience, NACs can specialize in areas like hospice/palliative care, restorative/rehabilitation care, dementia/memory care, or activities coordination.
• Healthcare Administration or Education: With further education and experience, NACs can move into management, staff development, or become NATP instructors (requires RN licensure and specific DOH qualifications).

Many Washington healthcare employers, especially larger hospital systems and unionized facilities, offer tuition assistance, scholarships, or career ladder programs. State programs like Worker Retraining or Opportunity Grant can also help fund further education.

15. NAC Training Costs & Financial Aid in Washington

The cost of Nursing Assistant Training Programs (NATPs) in Washington can vary:

Program Type	Typical Tuition Range (WA)	Additional Fees (Background Checks, Books, Uniform, Exam, DOH Application, etc. Estimate)	Common Financial Aid Options
Washington Community/Technical College	$1,000 – $2,000 (may include some fees)	$200 – $450 (Credentia exam fee ~$143, DOH application fee ~$85, background checks, books, uniform)	Worker Retraining Grant, Opportunity Grant, Pell Grants (if eligible), WIOA (WorkSource WA), BFET, scholarships, college payment plans.
Private Career School	$1,200 – $2,500+	$250 – $500	School payment plans, WIOA, private loans, some scholarships.
Facility-Based (SNF) Training	Often Free (if offered by an approved nursing facility to prospective or current employees, by federal law they cannot charge for any portion of the training or exam fees if you work for them).	Minimal or covered by facility. Background check and DOH application fees might still apply initially.	Employer-sponsored.

Key Washington Financial Aid & Cost-Saving Tips:

• Worker Retraining Grant: For dislocated workers or those needing to upgrade skills; available at community/technical colleges.
• Opportunity Grant: Helps low-income adults train for high-wage, high-demand careers (NAC often qualifies) at WA community/technical colleges; covers tuition, fees, and sometimes books/supplies.
• Basic Food Employment and Training (BFET): If receiving Basic Food (SNAP), BFET can help pay for training and support services.
• WorkSource Washington (WIOA): Contact your local WorkSource office for information on WIOA (Workforce Innovation and Opportunity Act) training grants.
• FAFSA (Free Application for Federal Student Aid): Complete for federal Pell Grants if attending an eligible college program.
• Employer-Sponsored Training: Inquire with local nursing homes about free DOH-approved NATPs. Federal law mandates that if a nursing home offers the training and you work for them (or have an offer), they cannot charge you for any portion of that training, the competency exam, or the DOH application fee for initial certification if the facility pays it directly.

Always get a detailed, itemized breakdown of ALL costs before enrolling: tuition, DOH application fee, WSP/DSHS background check fees, Credentia NNAAP® exam fee, textbook, uniform, equipment, physical exam/TB test, CPR certification (if required separately).

Conclusion: Start Your NAC Journey in Washington Today!

Becoming a Nursing Assistant-Certified in Washington State is a significant and rewarding step towards a stable and fulfilling career in the dynamic healthcare field. The Evergreen State offers numerous opportunities for dedicated, compassionate individuals committed to providing quality care. By thoroughly understanding Washington's specific requirements through DOH, choosing a quality DOH-approved training program, successfully navigating the background check processes and the Credentia NNAAP® Examination, and committing to annual renewal including continuing education, you will be well-prepared for a successful career.

Your journey to making a profound difference in people's lives begins with your initiative. Use the resources in this guide to research programs in your area of Washington and take that important first step.

Visit the Washington State Department of Health (DOH) Nursing Assistant Certified page and the Credentia Washington Nurse Aide page for official program information, forms, candidate handbooks, exam details, and to embark on your path. A vital role in Washington's healthcare system awaits you!

References & Further Reading (Washington)

1. U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, "Nursing Assistants and Orderlies" — www.bls.gov/ooh/healthcare/nursing-assistants.htm
2. U.S. Bureau of Labor Statistics, Occupational Employment Statistics, "May 2023 State Occupational Employment and Wage Estimates Washington - 31-1131 Nursing Assistants" — www.bls.gov/oes/current/oes_wa.htm#31-1131
3. Washington State Department of Health (DOH) - Nursing Assistant-Certified Program — doh.wa.gov/licenses-permits-and-certificates/nursing-commission/nursing-assistant/nursing-assistant-certified
4. DOH - Approved Nursing Assistant Training Programs List — nursingcare.wa.gov/training-education/nursing-assistant-training-programs
5. Credentia - Washington Nurse Aide Examination Program — credentia.com/test-takers/wa_cna (Access Candidate Handbook here)
6. DOH Provider Credential Search (for Registry lookup) — fortress.wa.gov/doh/providercredentialsearch/
7. WorkSource Washington (for WIOA and job/training resources) — www.worksourcewa.com/
8. Washington State Board for Community & Technical Colleges (SBCTC) - For Opportunity Grant, Worker Retraining — www.sbctc.edu/
9. DSHS Background Check Central Unit (BCCU) — www.dshs.wa.gov/ffa/background-check-central-unit