Certified Nursing Assistant Ratios

Our Take: New Jersey, and the nation as a whole, is in the midst of a shortage of certified nursing assistants, as documented by the state Department of Labor. There simply are not enough CNAs available to meet the ratio proposed in state legislation. Healthcare professionals should make staffing plans that include all disciplines caring for our frail seniors – nurses, CNAs, social workers, etc. – based on the specific health and psychosocial needs of the residents in their facilities, rather than using a one-size-fits-all ratio set in Trenton.

Certified nursing assistants are a critical part of the care team in New Jersey’s nursing homes. They contribute significantly to the quality of life of nursing home residents, working in partnership with nurses, social workers and others who meet the physical, emotional, psychological and social needs of residents.


The state and the nation are in the midst of a shortage of CNAs. Projections show that the nation will need 95,000 additional CNAs by 2025 to help care for our aging population. Today in New Jersey, nursing homes are recruiting and hiring CNAs for approximately 1,800 open positions.

Data from the New Jersey Department of Labor shows:

  • There is a projected demand for an additional 8,200 CNAs over the next decade.
  • There are approximately 2,060 annual job openings for CNAs. About 60 percent of those are due to existing vacancies, while about 40 percent are pure growth in demand.
  • There have been more than 4,000 job postings for CNAs in New Jersey between June 2017-May 2018, and many of those postings reflected multiple positions available.


Too much of this discussion has focused on plugging numbers into a formula, instead of proactively addressing the shortage of healthcare workers and the needs of nursing home residents both today and in the years to come. NJHA advocates for proactive solutions such as:

  • CNA reciprocity, which would create a seamless, accessible pathway for CNAs certified in other states to obtain New Jersey certification without having to go through the entire training and certification process. This streamlining of the bureaucratic process for CNAs does not exist in New Jersey today.
  • Scholarships for individuals who want to enroll in the nurse aide training program through the N.J. Department of Health, using penalty fees gathered by the state.
  • A tax credit for CNAs’ tuition costs. After working one year as a CNA, individuals would be able to claim a one-time capped tax credit for their training costs.
  • Government-funded grants to expand access to CNA training in underserved areas of the state.
  • Paid dining assistants, which free up CNAs to use their skills and training for other needs of nursing home residents. New Jersey recently agreed to permit the use of paid dining assistants through a state-approved curriculum developed by NJHA in conjunction with its members and the Health Care Association of New Jersey.