Advantages and Disadvantages of Running a Facility Based CNA Program

A facility based CNA program is not cheap to run. Before you decide whether to proceed, or pass on running one it is important to weight the advantages versus the disadvantages, and determine if it is a good fit for your facility.


    You have control over class start dates, schedules and length. This allows you to conduct CNA training to fit your needs and your facility’s operational rhythm.

  • You can pick the people you want for the program. Some of the most successful CNA students are people who already work for your facility in support roles (housekeepers, activities, food service), and the family of people who already work for you.
  • You get the students throughout their training, and by the time they graduate you will know which ones you want to hire, and which ones you do not.
  • The MediCal reimbursement system is designed to reward facilities that conduct regular CNA training. All costs associated with CNA programs are reimbursable with the highest caps, and these costs will be reflected with higher rates once they have been captured by the audit process
  • Once a student learns a skill, and is certified on it by their instructor, they can work in your facility as a Nurse Assistant (NA), and the hours count toward your 3.5 hour staffing requirement the same as a CNA.


  • You have to hire the students at the start of their training, and you cannot make them pay any of the cost of training. Due to existing wage-passthroughs, the minimum wage for students in a facility based CNA training program is $10.90 an hour during their first 90 days, and rises to $11.08 after that. (link to Medi-Cal Minimum Wage file)
  • You may not count classroom or clinical training hours toward you 3.5 staffing requirement, even when those hours are spent on the floor assisting your residents.
  • You cannot compel your students to remain at your building after they get their CNA. They remain “at will” employees at all times, and you cannot charge them for any of the costs associated with the training program.

Ways to Maximize Your Advantage

Even with the wage-passthroughs a CNA student, working as an NA, costs you less on an hourly basis than a CNA who already has their certification. The average median CNA hourly wage in California is $16.85 according to’s January 30, 2018 report. (link to An NA working as a CNA costs $5.90 cents less an hour in the first 90 days, and $5.78 an hour less starting day 91. Students can work for you for up to 4 months before they get their CNA certification. For comparison purposes:

Training Hours
NA Hours
NA Student for Training plus NA Hours Experienced CNA for 3.5 NA Hours
10 Week CNA Program (400 hours) 200 (66 Classroom, 118 Clinical, 26 Other) 200 $4,360
15 Week CNA Program (600 hours) 200 (66 Classroom, 118 Clinical, 26 Other) 404 $6,554.40
  • You can expect CNA wages to begin climbing as soon as facilities start staffing up for 3.5 and as the supply of already certified CNAs begins to dry up, so the advantages of CNA student labor will increase.
  • Provide extra staffing for meals. Front load the training for meals, and the CNA students can begin assisting with meal service starting as early as their first week of training. Their initial, training time cannot be counted toward your 3.5 staffing requirements, but once they’ve been certified by their instructor they can.
  • After the initial 2-3 weeks of training, you can start assigning students to perform their non-training hours during nights, or weekends, or other difficult to fill shifts. Since they are regular employees during these non-training times, you can also offer them overtime shifts.

Training CNAs in your facility