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South Carolina Certified Nursing Assistant — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Certified Nurse Aide (CNA)

Nurse aide certification and active listing on the South Carolina Nurse Aide Registry. The four-month exception for non-certified trainees is an employment exemption under Regulation 60-17 section 603(C).

Licensing authority: South Carolina Department of Health and Human Services · Application information

Examination — E1, South Carolina state approved training

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Training
Complete a South Carolina state-approved 100-hour nurse aide program including 40 clinical hours within the preceding 24 months.
Examination — E2, out of state training

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Training
Complete a 100-hour state-approved nurse aide program in another jurisdiction within 24 months, including clinical training.
Training Evidence
Upload a completion certificate, diploma, or letter on state or program letterhead stating classroom and clinical hours.
Reactivation — E3, previously trained South Carolina registry applicant

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Exact Two Year Boundary
Eligibility E3 permits a certificate not expired for more than 24 months. The current Application and Scheduling page, SC DHHS, also states: "If the CNA (Certified Nursing Assistant) certificate has lapsed and it has been two (2) or more years since the expiration date, the following must occur:" and requires retraining. Both passages involve the same two NNAAP examinations; the applicant must account for the stated retraining demand at exactly two years.
Lapsed Status
Certificate must be in good standing and not expired for more than 24 months.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Prior Training
Previously complete a 100-hour South Carolina state-approved nurse aide training program.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Examination — E4, out of state registry applicant

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Prior Training
Complete a 100-hour state-approved nurse aide training program with clinical training.
Registry Status
Certificate must be in good standing and not expired for more than 24 months.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Training Evidence
Upload the completion certificate, diploma, or state/program letter stating classroom and clinical hours.
Examination — E5, student nurse, LPN/RN graduate, or military candidate

All of the following:

Agency Approval
Contact SCDHHS at scnar@scdhhs.gov for an eligibility determination before applying.
Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Eligibility Category
Student nurse, LPN or RN graduate, or military candidate.
Nursing Study Recency
RN/LPN students must have completed Fundamentals of Nursing within two years of testing unless still attending nursing school; SCDHHS determines eligibility.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Reactivation — certification expired more than two years

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Lapsed Status
Certification expired more than two years ago.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Training
Retrain at a 100-hour state-approved nurse aide training program and pass both NNAAP examinations before reactivation.
Reactivation — lapsed certification without prior 100 hour training

All of the following:

Application
Submit the Application for Registration by Competency Examination through the Credentia Platform and obtain application approval before scheduling.
Lapsed Status
Certification has lapsed and the applicant has not previously completed a 100-hour state-approved nurse aide training program.
Oral Alternative
The English or Spanish Oral Examination may replace the written format within the registered NNAAP Written (or Oral) Examination; request the oral format in the examination application.
Passing Window And Attempts
Pass both NNAAP parts within two years of training completion or three attempts, whichever comes first; otherwise complete a 100-hour state-approved training program and retake both parts.
Payment
Pay the required examination fees; the current Application and Scheduling instructions state that fees are non-refundable and non-transferable once submitted.
Screening
Answer the felony conviction/guilty-plea and abuse-registry screening questions; a yes response requires SCDHHS review before testing or retesting.
Skills Medical Eligibility
Candidates on restricted activity or light duty may take the written/oral examination but cannot take the Skills Evaluation until medical documentation establishes full, unrestricted duty.
Sponsorship
Candidates employed as nurse aides or with a written offer of employment from a Medicare/Medicaid-certified nursing home must be sponsored by that nursing home.
Training
Complete a 100-hour state-approved training program and pass both NNAAP examinations before reactivation.
Certification by reciprocity — active out of state nurse aide
No examination is required for this applicant pathway.
Application
Submit the online reciprocity application and supporting documents for verification.
Certificate Expiration
Retain the expiration date from the original certification.
Existing Certification
Be actively listed in good standing on another jurisdiction's nurse aide registry in accordance with OBRA 1987 competency-evaluation requirements.
Prior Training
Previously complete at least a 100-hour basic state-approved nurse aide course.
Resident Contact
The SCDHHS February 2026 provider manual prohibits resident contact until reciprocity is granted or the written and skills competency evaluation is passed; the examination option is an alternative to granted reciprocity, not an examination required to grant this route.

Official no-examination sources

Effective from 2026-09-22.

Renewal — continued registry enrollment
No examination is required for this applicant pathway.
Application
Submit the continued-enrollment application through the Credentia Platform.
Fee
The current handbook states a $35 non-refundable, non-transferable recertification fee effective July 1, 2020; a Medicaid-certified employer reimburses the employee upon receipt submission.
Paid Work
Perform at least eight hours of paid nursing or nursing-related services in the 24 months preceding expiration; the current Credentia page specifies one documented day of eight consecutive hours under an RN or LPN.
Renewal Period
The certificate is valid for 24 months; renew to remain active.

Official no-examination sources

Effective from 2026-09-22.

National Nurse Aide Assessment Program (NNAAP) Skills Evaluation

This assessment does not have a question bank.

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia at test centers
Format
Performance evaluation at a test center, scored and retaken separately from the Written (or Oral) Examination: the candidate performs five skills on a candidate volunteer acting as the client and is rated by a Nurse Aide Evaluator; each skill is scored Satisfactory or Unsatisfactory and all five must be Satisfactory to pass
Time limit
30 minutes
Examination sources

NNAAP Written (or Oral) Examination

Provider
Credentia Nurse Aide LLC (develops and manages the NNAAP exam); administered by Credentia online or at test centers
Format
Multiple-choice examination taken online or at a test center, in English or Spanish, scored and retaken separately from the Skills Evaluation; candidates may choose the Oral Examination form, in which the multiple-choice questions are read aloud by recorded voice (MP3 player at test centers) and ten reading comprehension (word recognition) questions are added, and both Oral sections must be passed
Exam questions
70 multiple-choice items: 60 scored and 10 pretest (non-scored); the Oral form has 60 multiple-choice items and 10 reading comprehension (word recognition) items
Time limit
2 hours
Examination outline
  • I. Physical Care Skills — A. Activities of Daily Living (22% of the exam; 13 questions) (22%)
    • Activities of Daily Living — 1. Hygiene
    • Activities of Daily Living — 2. Dressing and Grooming
    • Activities of Daily Living — 3. Nutrition and Hydration
    • Activities of Daily Living — 4. Elimination
    • Activities of Daily Living — 5. Rest/Sleep/Comfort
  • I. Physical Care Skills — B. Basic Nursing Skills (35% of the exam; 21 questions) (35%)
    • Basic Nursing Skills — 1. Infection Control
    • Basic Nursing Skills — 2. Safety/Emergency
    • Basic Nursing Skills — 3. Therapeutic/Technical Procedures
    • Basic Nursing Skills — 4. Data Collection and Reporting
  • I. Physical Care Skills — C. Self-Care and Independence (7% of the exam; 4 questions) (7%)
    • Self-Care and Independence
  • II. Psychosocial Care Skills — A. Emotional and Mental Health Needs (8% of the exam; 5 questions) (8%)
    • Emotional and Mental Health Needs
  • II. Psychosocial Care Skills — B. Spiritual and Cultural Needs (2% of the exam; 1 question) (2%)
    • Spiritual and Cultural Needs
  • III. Role of the Nurse Aide — A. Communication (7% of the exam; 4 questions) (7%)
    • Communication
  • III. Role of the Nurse Aide — B. Client Rights (8% of the exam; 5 questions) (8%)
    • Client Rights
  • III. Role of the Nurse Aide — C. Legal and Ethical Behavior (5% of the exam; 3 questions) (5%)
    • Legal and Ethical Behavior
  • III. Role of the Nurse Aide — D. Member of the Health Care Team (6% of the exam; 4 questions) (6%)
    • Member of the Health Care Team
Examination sources