Increased Need for Certified Nursing Assistant (CNA) Training Schools In California

The ongoing Coronavirus Pandemic has challenged healthcare organizations all over the world. Shortages of necessary tools, lack of personal protective equipment, and trained professionals to take care of patients have only increased the burdens facilities faced before COVID-19. The staffing crisis in healthcare facilities, especially in skilled nursing facilities (SNF), is not new. Healthcare regulatory agencies continue to make laws to ensure that staffing ratios are safe, but challenges still exist.

CNA to resident ratio in California

In the United States, state healthcare regulators continue to work on proper staffing ratios to ensure skilled nursing facilities (SNF) have adequate care. Before 2018, California had a requirement that SNFs have at least 3.2 hours of direct care daily for each resident 2018; however, there was no requirement about CNA hours spent with each resident. In 2018, a California minimum staffing law mandated that residents in skilled nursing facilities receive at least 3.5 hours of direct patient care each day. The law required that out of the 3.5 hours of direct care that residents received 2.4 hours needed to be performed by a certified nursing assistant. This has increased the demand for CNA’s in California significantly.

There is no doubt that this new requirement is necessary, but how can these facilities comply with these rules when they are understaffed? According to the Office of Statewide Health Planning and Development (OSHPD), although about 58% of skilled nursing facilities meet the updated staffing requirements, 42% are unable to meet the requirements. OSHPD suggests that an increased need of about 2,400 additional CNAs is required for skilled nursing facilities to meet the updated staffing and patient care hours–increasing the total number of CNAs currently working in SNFs by between 5% and 7.5%.

More CNA training schools urgently needed in California

There is an urgent need for CNA training schools to fill the void in CNA staffing. For residents to receive the attention and care required for better outcomes, there’s a need for quality training schools and programs that equip CNAs to be professional, competent, and safe. Critical factors to consider are:

  • Adequate Train the Trainer programs for owners and administrators of schools for skilled nursing care.
  • Continuous training and education of CNAs by training programs and employers upon graduation
  • An accessible team of mentors, coaches and resource persons to assist owners of CNA training schools

As of 2018, it was estimated that there were about 32,000 CNAs in the state who served nearly 100,000 patients annually. Staff retention is a challenge for administrators and healthcare officials. 50% of California’s counties were identified by the public health department to have CNA shortages.

The need for more CNA training schools and programs in California is urgent! Due to the lack of CNAs, some nursing homes may have to reduce resident intake due to a lack of CNAs.

Although some SNFs have attempted to train their own CNAs, they have not been able to train enough staff to fill CNA jobs. The Los Angeles Times reported that CNA training programs, by SNFs, were reduced by as much as 48 percent in 2018. There is a critical need for private schools to set up CNA training programs to fill the staffing void. Due to the numerous requirements on the state and federal levels regulating CNA training schools, there is a need for prospective training school owners to consult trusted professionals on how to set up programs successfully.

California’s healthcare regulatory agencies seek to improve patient care and outcomes in skilled nursing facilities. There is an essential need for trained personnel–especially CNAs. This requires a collaboration between the state, healthcare agencies, and training programs and schools to place skilled, competent, compassionate CNAs in the community.

If you are ready to start a CNA training program or want to add a program to your facility, we can help you get started today! Visit us online at to learn more about how we can help you or feel free to email us at

This article was written by Henrietta Osei