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chapter-457a•Hawaii Revised Statutes, Chapter 457A — Nurse Aides
chapter-457aHaw. Rev. Stat. ch. 457ACode1 janv. 1990
Division 2. Business — Title 25. 25a
Hawaii Revised Statutes as published by the Hawaii State Legislature (files updated 1/5/2026 7:15 PM).
(a) The legislature recognizes that 42 United States Code sections 1395i-3 and 1396r require nurse aides working in nursing facilities participating in medicare and medicaid programs to be certified.
(b) The legislature also recognizes that nurse aides who work in state-licensed or state-certified health care settings should be certified for the purpose of consumer safety and held to similar standards of competency and evaluation appropriate for these settings. This chapter implements 42 United States Code sections 1395i-3 and 1396r with respect to:
(1) Establishing the State's regulatory scheme for certifying nurse aides;
(2) Defining the scope of regulation;
(3) Establishing standards for certification and biennial recertification; and
(4) Establishing an interagency agreement between the state agencies responsible for various aspects of the program.
[L 1990, c 271, pt of §1; am L 1994, c 185, §3(1); am L 2007, c 226, §5]
As used in this chapter:
"Certified nurse aide" means a nurse aide who has met the requirements for certification under section 457A-7 or 457A-8.
"Director" means the director of commerce and consumer affairs.
"Medicare or medicaid certified nursing facility" means any intermediate care facility or skilled nursing facility licensed pursuant to section 321-11(10) and certified by the department of health in accordance with 42 United States Code sections 1395i-3 and 1396r.
"Medicare or medicaid nurse aide" means a certified nurse aide who works in a medicare or medicaid certified nursing facility.
"Nurse aide" means a person who performs a variety of duties relating to patients and patient care while working under the supervision of a nurse, including assisting patients in all activities of daily living such as serving and collecting food trays, and helping patients get out of bed, bathe, and dress. A nurse aide may also assist a nurse by changing bed linens, delivering messages, and sterilizing instruments.
"State-licensed or state-certified health care settings" means health care settings, other than medicare or medicaid certified nursing facilities, which are regulated by the department of health.
"Substantiated finding" means documentation of an investigation by the State that leads the State to conclude that an allegation is valid, including:
(1) The nature of the allegation and the evidence that led to the conclusion;
(2) The date of the hearing, if the individual chose to have one, and its outcome;
(3) A statement of the individual disputing the allegation, if the individual chose to make one; or
(4) A criminal conviction.
[L 2007, c 226, pt of §4; am L 2016, c 21, §2]
(a) The director shall implement the provisions of this chapter, in accordance with 42 United States Code sections 1395i-3 and 1396r, that relate to:
(1) The minimum requirements and standards for certification as a nurse aide;
(2) Examination requirements, including the passing score;
(3) Maintenance requirements for continued certification on a biennial basis; and
(4) Implementation of a certified nurse aide registry.
(b) The director of health shall implement this chapter in accordance with 42 United States Code sections 1395i-3 and 1396r, that relate to disciplining certified nurse aides who are employed in:
(1) Nursing facilities participating in medicare and medicaid programs; and
(2) Health care settings licensed or certified by the department of health.
(c) The director of human services shall implement this chapter in accordance with 42 United States Code sections 1395i-3 and 1396r, that relate to training programs for nurse aides and recertification; provided that recertification shall be required not less than every two years and the number of continuing education hours required for recertification shall not exceed twenty-four hours, except as specified by federal law.
[L 1990, c 271, pt of §1; am L 1994, c 185, §3(2); am L 2007, c 226, §6; am L 2009, c 108, §3; am L 2016, c 21, §3]
(a) The director, in accordance with chapters 91 and 92, shall adopt rules to implement the provisions of this chapter in accordance with 42 United States Code sections 1395i-3 and 1396r and the federal regulations adopted pursuant thereto, that relate to:
(1) The minimum requirements necessary for certification as a nurse aide;
(2) Examination requirements, including the passing score and provisions for contesting examination results;
(3) Maintenance requirements for continued certification; and
(4) Implementation and maintenance of a nurse aide registry of certified nurse aides employed in medicare or medicaid certified nursing facilities and certified nurse aides in other state-licensed and state-certified health care settings.
(b) The director shall issue certificates to qualified nurse aides and shall be responsible for maintenance of an up-to-date nurse aide registry that shall include the names of certified nurse aides, their places of employment, and all information that is reported by the department of health and the department of human services. The director's role, with regard to the disciplining of certified nurse aides, shall be limited to the placement into the certified nurse aide registry of all information and substantiated findings from the department of health, as required by 42 United States Code sections 1395i-3 and 1396r, and the department of human services, within ten working days of the finding, which information shall permanently remain in the registry except if:
(1) The finding was made in error;
(2) The individual is found not guilty in court; or
(3) The State receives notification of the individual's death.
[L 1990, c 271, pt of §1; am L 1994, c 185, §3(3); am L 2007, c 226, §7; am L 2016, c 21, §4]
The director may contract with a professional testing service that is qualified to test the competency of nurse aides. The department may require that fees for services be paid directly to the professional testing service.
[L 1990, c 271, pt of §1]
The director may establish fees for services rendered to carry out the purposes of this chapter.
[L 1990, c 271, pt of §1]
[§457A-6] Certification required. Except as otherwise provided in this chapter, no person shall:
(1) Represent one's self as a certified nurse aide;
(2) Imply, in any manner, that one's self is a certified nurse aide; or
(3) Use the abbreviation "C.N.A." or any other words, letters, signs, or devices to identify one's self as a certified nurse aide;
without having first obtained certification as provided in this chapter.
[L 2007, c 226, pt of §4]
(a) To be certified as a medicare or medicaid nurse aide, an applicant shall successfully complete:
(1) Training in a training program approved by the director of human services under section 346-46; and
(2) A nurse aide examination approved by the director.
(b) No person shall be permitted to take the examination who has not complied with the training requirements established by the director of human services in accordance with 42 United States Code sections 1395i-3 and 1396r.
(c) Reciprocity shall be granted to nurse aides who have completed a state-approved program that meets both federal and state requirements.
(d) Nurse aides employed in medicare or medicaid certified nursing facilities shall meet both federal and state requirements.
(e) Maintenance requirements for the recertification process shall be on a biennial basis, and shall include an annual performance review and in-service training and employment in a medicare or medicaid facility as required by federal and state law.
(f) No charge shall be imposed on medicare or medicaid certified nurse aides for the maintenance of the nurse aide registry.
[L 2007, c 226, pt of §4]
(a) This certification applies to nurse aides working in state-licensed and state-certified health care settings other than a medicare or medicaid certified nursing facility.
(b) To be certified, an applicant shall successfully complete:
(1) Training in a training program approved by the director of human services under section 346-46; and
(2) A nurse aide examination approved by the director.
(c) Fees may be imposed for services rendered to carry out the purposes of this section.
(d) Reciprocity shall be granted to qualified nurse aides who have completed a state-approved program, the requirements of which are comparable to the requirements of this chapter.
(e) Maintenance requirements for the recertification process shall be required on a biennial basis and shall include a competency evaluation approved by the department of human services, and employment in a state-licensed or state-certified health care setting.
[L 2007, c 226, pt of §4]
(a) Notwithstanding any law to the contrary, the director shall automatically revoke a certification or deny an application to renew, restore, or reinstate a certification under either of the following circumstances:
(1) The person has been convicted in any court in or outside of this State of any offense that, if committed or attempted in this State, based on the elements of the convicted offense, would have been punishable as one or more of the offenses described in chapter 846E; or
(2) The person has been required to register as a sex offender pursuant to chapter 846E, regardless of whether the related conviction has been appealed.
(b) The director shall notify the person of the certification revocation or denial of application to renew, restore, or reinstate the certification and of the right to elect to have a hearing as provided in subsection (c).
(c) Upon revocation of the certification or denial of an application to renew, restore, or reinstate, the person may file a written request for a hearing with the director within ten days of the notice. The hearing shall be held within thirty days of the revocation or denial. The proceeding shall be conducted in accordance with chapter 91.
(d) For the purposes of enforcement of this section, a plea or verdict of guilty, or a conviction after a plea of nolo contendere, shall be deemed a conviction. The record of conviction shall be conclusive evidence of the fact that the conviction occurred.
(e) If the related conviction of the person is overturned upon appeal, the revocation or denial ordered pursuant to this section shall automatically cease. Nothing in this subsection shall prohibit the director from pursuing disciplinary action based on any cause other than the overturned conviction.
(f) Any final order of discipline taken pursuant to this section shall be a matter of public record.
(g) The director shall not restore, renew, or otherwise reinstate the certification of a person under any of the following circumstances:
(1) The person has been required to register as a sex offender pursuant to chapter 846E, regardless of whether the conviction has been appealed; and
(2) The person engaged in the offense with a patient or client, or with a former patient or client if the relationship was terminated primarily for the purpose of committing the offense.
[L 2025, c 273, §16]
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