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CNA Apprenticeship: Filling a gap in skills training

Photo of Lorraine

One of the barriers that prevents people from taking the first step toward their dream nursing career is the cost of the training necessary to earn certification. Paying for a Certified Nursing Assistant (CNA) course out of pocket is not feasible for most low wage workers living paycheck to paycheck, as squeezing in learning time between work hours and other personal responsibilities can pose an insurmountable challenge.

The Center for Caregiver Advancement’s CNA Registered Apprenticeship program for nursing home workers is helping to mitigate those barriers by providing an opportunity to get paid while they learn. And the best part? The training is free.

The apprenticeship has opened new doors for caregivers, such as Lorraine Kelly Matkins. 

“Sometimes people struggle financially […] the cost is a barrier for them to pursue this,” she said. “If you’re interested in pursuing nursing or becoming a CNA […] you basically get a free education in the CNA Apprenticeship program. You get to start your career path somewhere with help and support, which normally, you wouldn’t get in a regular program.” 

Lorraine is a participant of the first CNA Apprenticeship Program offered by and CCA’s Education Fund. The Education Fund partnered with EmpRes Healthcare and SEIU Local 2015 to provide this program. The program’s pilot cohort in 2021 has a 100% success rate: All seven workers who completed training through the earn-and-learn model passed their state certification exams and were promoted to CNAs.

The program was launched to provide career pathways for nursing home workers and to address a critical staffing shortage at skilled nursing facilities. Funded by the Healthcare Career Advancement Program (H-CAP), a national labor-management organization, the program is listed as a Registered Apprenticeship with the U.S. Department of Labor.

It provides workers the opportunity to get paid as nursing aides while they pursue training to become licensed CNAs. The training is provided at no cost to the worker,  all program-related fees and materials are covered by the program and students receive robust wrap around services throughout the entire duration of the program, including ongoing coaching and mentorship. .

The program also eliminates the all-too-common stressor of finding a job afterwards, as the participant already works at a skilled nursing facility and has a support system of supervisors, administrators, and mentors. The participant is also guaranteed a promotion to a CNA position at their associated facility once passing the state exam.  

The apprenticeship program requires a strong commitment from the worker – after all, the program is six months in length, and requires apprentices to complete all core CNA apprenticeship competencies. But the payoff is worth it, says Lorraine. Lorraine is now working as a CNA at Katherine Healthcare, an Empres facility in Salinas. For her, being a CNA is rewarding, not just in her day-to-day tasks, but also in the overall impact she has on the residents.

“The thing that I find most satisfying is seeing how much we help the residents. [..] even just talking to them or having a conversation and hearing them tell us how much they appreciate that. I really like that feeling of knowing that I helped someone else,” she said. 

The CNA Apprenticeship Program provides long-term care workers a unique opportunity for career advancement. Lorraine is now taking prerequisite courses to get into an accredited nursing program with her eyes on becoming a Registered Nurse (RN). 

For the facility, the CNA Apprenticeship program offers the benefit of streamlined recruitment, with CCA and SEIU Local 2015 helping identify and enroll participants who want to become part of a vital workforce.  

Steve Biesinger, Executive Director at Katherine Healthcare, says he’s thrilled Katherine got involved in the Apprenticeship Program as it’s been immensely beneficial for his facility. Like Lorraine, the apprentices who have passed their state exams since the program started in summer 2021 have since become quality, experienced CNAs working at three Empres facilities in Salinas and Vallejo. 

“It is something that gives an opportunity […] in a category of classification of workers that there’s a real shortage of. CNAs are just in short supply, and really getting good CNAs are even harder, because there’s a high turnover,” says Steve. “So anytime we have the opportunity to really participate in the selection and the training and the nurturing of that type of a candidate, it’s a win-win.”

The Apprenticeship Program comes at no cost to the participant, thanks to a grant from Healthcare Career Advancement (H-CAP). The H-CAP grant also provides stipends that help offset the costs of childcare or transportation, if needed. The employer pays the participants’ wages as nursing aides and for the hours they are in training, then promotes the apprentices to CNAs as soon as they pass the state certification exam. This unique structure is mutually beneficial to both workers, employers and the union SEIU 2015. 

“The model is much, much better than just going to CNA school,” says Steve. “No other program is set up like that.”

Katherine Healthcare is already starting to see the benefits of the program come to fruition with the first cohort of apprenticeship graduates. 

Aiza Suan, Director of Staff Development at Katherine Healthcare, says  “…now  we have three additional CNAs, it’s not a struggle for us to look for a replacement if ever someone calls off. And so, we think [the apprenticeship] really helped a lot.”

And no doubt it has. The CNA Apprenticeship Program leads to lower recruitment costs and higher productivity. Most crucially, the retention of highly skilled, confident, and motivated caregivers, like Lorraine, leads to improved industry-wide standards. 

A recent study of the nursing home workforce shows that the mean turnover rate percentage for CNAs can be as high as 129%. One of the goals of CCA’s training programs, especially the CNA certification and apprenticeship programs, is to help skilled nursing facilities address the industry’s staffing shortage and high turnover rate.

“I think it’s vital […] it’s so important to be able to have opportunities like this as a worker because I think it helps empower the sense that you can make a difference if you’re dedicated and make a difference if you are applying yourself. And I think being given a vote of confidence from the facility goes a long way in helping motivate you to stay there and do your best,” says Mitchel Lopez, a union representative at SEIU Local 2015.


Spanko, Alex. “Nursing Homes Have 94% Staff Turnover Rate – with Even Higher Churn at Low-Rated Facilities.” Skilled Nursing News, 2 Mar. 2021, https://skillednursingnews.com/2021/03/nursing-homes-have-94-staff-turnover-rate-with-even-higher-churn-at-low-rated-facilities/

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