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Direct Care Worker Registry Information for CNAs

In order to be employed in a nursing home, CNAs are required to be active on the DCW Registry. 

Direct care workers (DCWs) are responsible for the care of thousands of clients, patients, residents, or tenants in health care facilities throughout Iowa. DCWs provide assistance with daily activities, administer medications, and ease the burden for Iowa's elderly and persons with disabilities. In Iowa, only certified nursing assistants (CNAs), also referred to as nurse's aides, are placed on the Direct Care Worker Registry. 

CNAs may apply online to be added to the registry so they are eligible for work in an Iowa long-term care facility, and CNAs are only required to be on the registry if they are seeking employment in a long-term care facility (nursing home, skilled nursing facility, or a skilled or swing bed unit of a hospital). 

CNAs may visit the Health Facilities Division website to see if they are currently active on the registry. Select “DCW Search” on the left side of the page, and search by Registry ID number, first or last name, city, or county. 

To gain placement on the registry 

  1. The CNA candidate must take and complete the 75-hour course. 

  1. The candidate must pass both a written and a skills test within four months of their hire date. 

  1. Both tests must be passed within three attempts. If a candidate does not pass the written OR skills test after three attempts, they must retake the 75-hour course AND begin a new testing cycle. 

  1. Upon successful completion of the written and skills tests, registry staff will receive notice from the testing entity and the CNA will be placed on the registry. Processing time varies; please allow at least two weeks. 

To remain active on the registry the Centers for Medicare and Medicaid Services (CMS) requires that a CNA perform at least a day of nursing or nursing-related duties every 24 months.  

Long-term care facilities are the only entities mandated by state and federal law to verify eligibility and report qualifying employment to the registry. However, health care employment agencies that employ CNAs at long-term care facilities must also report hours for their employees working in long-term care facilities. Entities other than long-term care facilities (and health care employment agencies who staff CNAs in long-term care facilities) are not required by state or federal law to verify eligibility or report long-term care-eligible employment. However, the only way a CNA can remain active on the Iowa Direct Care Worker Registry is if their Iowa employer reports their hours to registry staff.  

Before the CNA's status on the registry expires, a long-term care facility or other qualifying federally-certified entity can report employment for a CNA by logging in to DIA's Health Facilities Database/Direct Care Worker Registry. 

If an entity does not update CNA new hires as outlined, the registry will not accurately reflect the CNA’s current status. 

The other entity types that can report a CNA's hours electronically to the Iowa Direct Care Worker Registry: 

  • Hospices 

  • Hospitals 

  • Home health care agencies (HHAs) 

  • Ambulatory surgical centers (ASCs) 

You can read more here.