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Employers expand education and career opportunities for CNAs

August 16, 2011
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In PHI’s recent effort to document how LTC employers are investing in their direct-care workers (a project funded by the Hitachi Foundation), we found multiple employers offering expanded education and advancement opportunities. Employers are searching for ways to get the most value out of their staff—and to increase retention rates among committed and caring individuals.

For example, New Courtland Network in Philadelphia founded a nursing education center where employees can advance their careers along the organization’s “Ladder of Opportunity.” The Center offers free CNA training, an advanced CNA course (CNA specialist) and LPN training. For more advanced nursing courses—including RN, BSN and MSN—New Courtland provides tuition reimbursement.

The CNA specialist course is a seven-week training that focuses on nutrition, wound prevention and skin care, restorative care, and dementia care. After successfully completing the training, CNAs take on new administrative and specialty care responsibilities and receive a $1/hour raise. The next step, an 18-month LPN degree program, is tough for some, but over the last decade, 50 employees have advanced from CNA to LPN positions.

Nicanor Palicarpio, a Filipino employee, began his career at New Courtland as a housekeeper. He has used the free training to advance first to a CNA position, then to CNA specialist, and he is now pursuing his LPN degree. Palicarpio notes that he feels grateful for this opportunity: “If there is no employer doing that, everything would be coming from my pocket. And oh my, I can’t pay for it.”

Palicarpio, who has been with New Courtland for more than seven years, has not had an unusual experience. Among employees who take advantage of the Ladder of Opportunity, New Courtland has only a 10 percent turnover rate.

Loomis House, in Western Massachusetts, provides a four-step career ladder for its nursing assistants. At each stage of the ladder, additional training in areas such as end-of-life care, Alzheimer’s/dementia care and communication lead to incremental salary increases. The final step of the career ladder is a peer mentor position, which pays more than $1/hour more than entry-level CNA positions.

St. Peter Villa in Memphis, Tennessee, offers a three-step ladder that includes mentoring at Level II and assistant management responsibilities at Level III. To engage CNAs more deeply in advancing their careers through learning, St. Peter requires that CNAs teach two in-service trainings to their colleagues to advance to Level II. Level II CNAs also serve on facility committees that address issues such as fall prevention and infection control.


Susan Misiorski



Susan Misiorski is director of training and organizational development services for...



I have had a Career Ladder for nurse aides in place for over 5 years now, with self study at home and then application of knowledge portion. It provides bonus payments while you are in the process ( 1 year to complete) as well as a permanent pay raise when completed. It has taken us down from having to provide a TCEP course every 6 weeks to 2 per year ( from 64 trainees to 16 trainees per year). The TCEP course is good, but it just starts the process of being a good nurse aide. Further education will improve resident care.