The Certified Nurse Assistant Upskilling Program (CUSP) is a standardized, employer recognized program that provides CNA employees with a pathway for career advancement and ensures recognition for each micro-certification level attained with title and incremental wage increases. Participating facilities recognize and advertise CUSP as a workforce retention and enhancement program that adds to the quality of care delivered.

Employer participation in CUSP includes ensuring the opportunity to participate is available to all CNAs that meet program criteria and providing program infrastructure. Each program level includes a staff supervisor-trainer that will confirm CNA skill competency and provide program oversight. Program employee participation minimum criteria includes: six months of employment at each level, completion of micro-certification module and demonstration of skill competency for each level, incremental wage increase at each level and enrollment into the CUSP Statewide Registry, (company specific participation criteria is at the discretion of the employer).

The goal of the CNA Upskilling Program is to increase and retain the CNA workforce in the long-term care sector by instituting professional recognition of standardized advanced education and training levels, with statewide recognized job titles and incremental financial rewards.

• Employer participation in CUSP is voluntary.

• Participating employers agree to:

1.  Allow all CNA employees that meet criteria to participate in CUSP:

a) A minimum of six (6) months’ work experience at any given level, prior to advancement to the next skill level*;  

b) successful completion of CUSP authorized on-line, micro-certification course(s)*, and

c) successful return demonstration of skill competency.

2. Guarantee of an incremental, standardized wage increase for each CUSP level attained.

3. Enroll each CNA into the CUSP Registry as they complete each CUSP level (allows future employers and institutes of higher learning to confirm the CNA’s certificated level).

4. Cover all educational and registry fees associated with each CUSP level in addition to providing hourly wage for CNA to participate and complete micro-certification module(s).

5. Acknowledgment of new employee’s pre-existing CNA CUSP level of achievement upon hire. New hire wage rate to correspond to CNA level attained.

6. Complete and submit a CUSP letter of understanding to the CUSP Registry.

7. Provide a licensed nurse to be trained to oversee each program level and check CNA’s skill competency.

*If an existing CNA employee has been on the floor for 18 months and meets the employer eligibility criteria, the CNA may advance through levels II-IV without the incremental six months in-between each level.

*No level may be skipped, nor the micro-certification module specific to each level be substituted with any outside sourced education.

NA = Nurse Assistant Student
CNA I = Certified Nurse Assistant, first six (6) months of employment as a CNA.
CNA II = CNA I + Certified Preceptor, after first six (6) months of employment as a CNA I is completed, the employee is eligible to start level II training at month 7.
CNA III = CNA II + RNA, after first twelve (12) months of employment as a CNA II is completed, the employee is eligible to start level III training at month 13.
CNA IV = CNA III + Specialty Training (IVa = Behavioral Health Specialty, or IVb = Dementia Specialty) after first eighteen (18) months of employment as a CNA III is completed, the employee is eligible to start level IV training at month 19.

Micro-certification modules are provided by CUSP approved entities. These micro-certification modules are available on-line and are easily accessible across all electronic platforms. The CUSP provided education ensures uniform learning standards are achieved by all students. Uniform micro-certification guarantees that each CNA has achieved the minimum skill set for each level and that each level is recognized and transferable among all California employers participating in the program.

CNAs can assist in decreasing staff turnover during the first 90 days of employment by serving as a teacher, mentor and coach for the newest members of your team. This course is designed to equip CNAs with the tools necessary to serve as a bridge to help get the new staff through that critical phase of initial employment. They can also assist students who are conducting clinical rotations in the facility.

• Preceptor course provided by National Association of Health Care Assistants (NAHCA)

• Cost $99 for NAHCA members and $129 for non-members, curriculum and materials with CEUs are included. Not a member of NAHCA? Learn more here.
  

• Self-paced 8-12hour online training. The typical amount of time it takes a learner to complete the Preceptor course is 2-3 weeks. During this time the learner is asked to apply the concepts they are learning to their day-to-day routine for some of the modules’ exercises.

• Essay responses are required for each Module and are graded by the NAHCA staff, who give feedback to the learner based on their responses.

• The Certified Preceptor program will provide the participants with the information, tools, and techniques necessary to improve the orientation, training, and mentoring functions within the long-term care environment. Learners grasp of each of the core concepts will be measured by their responses to various quizzes and written responses. Ultimate success will be measured by correctly responding to the examination at the conclusion of the course. Participants must achieve a minimum score of 70% to be awarded the title of NAHCA Certified Preceptor.

• Course Objectives:

  • Identify the causes of short-and long term CNAs.

  • Discuss the benefits of increased retention

  • Explore the factors that distinguish a successful orientation compared to one with room for improvement.

  • List the characteristics of a successful Preceptor.

  • Complete the Attitude Adjustment Scale.

  • Evaluate the impact of attitude upon the orientation and retention processes.

  • Examine the effects of communication on training and retention.

  • Discuss the nature of passive and active listening.

  • Define the role of Mentor.

  • Describe techniques for motivating self and others.

It is part of care to ensure that all residents receive nursing interventions that promote the resident’s ability to adapt and adjust to living as independently and safely as possible. This concept actively focuses on achieving and maintaining optimal physical, mental and psychosocial functioning. The purpose of the Restorative Nurse Assistant (RNA), is to interact with the resident and provide skill practice that will improve and maintain function in physical abilities and activities of daily living and prevent further impairment.

• RNA course provided by National Association of Health Care Assistants (NAHCA)

• Cost $149 for NAHCA members, $179 for non-members, curriculum and materials with CEUs are included. Not a member of NAHCA? Learn more here.
  

• Self-paced 8-12 hours online, and 6 hours in person training and satisfactory return demonstration of skill competencies.

• Course Objectives (sample):

  • Understand the scope of service of the RNP (Restorative Nursing Program).

  • Review OBRA and Title 22 regulations related to the RNP.

  • Verbalize an understanding of admission and discharge criteria for the RNP.

  • Understand major muscle groups.

  • Understand three characteristics of the normal aging process.

  • Understand common medical problems/pathologies addressed by the RNP.

  • Identify cueing systems and useful compensatory strategies associated with dementia

  • Understand the difference between sensorineural and conductive hearing loss.

  • Verbalize/write three communication strategies to use post CVA

  • Demonstrate use of adaptive devices to assist with self-feeding

  • Demonstrate/verbalize/write three aids to facilitating a safe swallow.

The CARES® Dementia Basics™ Online Training Program provides caregivers with the core or “basic” information needed for dementia care. It focuses on person-centered care, the changes that happen to thinking skills as dementia progresses, how those changes impact behavior, and how to understand behavior as communication. It also includes an entire module on the CARES® Approach, a person-centered, easy-to-remember approach to care for any person in any situation and at any level of dementia thinking decline. The letters in CARES stand for: Connect with the Person, Assess Behavior, Respond Appropriately, Evaluate What Works, and Share with Others.

• Dementia Basics is provided by HealthCare Interactive CARES®.

• Cost, when taken with specialization IVa or IVb is $159 total, curriculum and CEUs included.

• Self-paced, 4-hour online training and satisfactory return demonstration of skill competencies.

• Course objectives (sample):
  After the course the student will:

  • Describe person-centered care

  • List three examples of how to learn more about a person with dementia

  • List four thinking skills affected by dementia

  • Identify activities that a person can do in each stage of Alzheimer’s disease.

  • List three ways you can change your approach or the environment to help a person with dementia to have a good day.

  • Identify three strategies you can use to respond to dementia-related behavior.

  • List two ways that using the CARES Approach can improve life for a person with dementia.

    
    

The Behavioral Health Specialty training provides CNAs with skills to identify and respond to issues involving resident mental health (diagnoses such as: major depression, schizophrenia, bipolar disorder and schizoaffective disorder) is critical, both to quality of care and to staff safety. CNAs first learn the CARES® 5-step method to respond to dementia-related behavior and challenging situations. The CARES® Serious Mental Illness™ Online Training Program focuses on care strategies for those with serious mental illness and how it differs from dementia. CNA’s with increased skill make a difference and impact the quality of resident’s lives.

• Behavioral Health Specialty is provided by HealthCare Interactive CARES®.

• Cost, when taken with pre-requisite CARES® Dementia Basics™ is $159 total, curriculum and CEUs included.

• Self-paced, total 8-hour online training and satisfactory return demonstration of skill competencies.

• Training time 8 – 10 hours, includes:

  • Dementia Care Basics™ (4, 1-hour modules) – see above “pre-requisite”

  • Behavioral Health Specialty (4, 1-hour modules)

    • This program describes the 4 major types of serious mental illness (SMI), how SMI differs from Alzheimer’s and dementia, and how you can develop care strategies for those with SMI.

Course Objectives (sample):

• After the course the student will be able to:

  • Define serious mental illness

  • Describe the major SMI categories

  • Identify differences between SMI and Dementia

  • Discuss the challenges of living with a serious mental illness

  • Recognize the perspectives of people

The CARES® Activities of Daily™ Living 4-Hour Online Training Program focuses on understanding each stage of dementia and how to respond to the changes that each stage presents while assisting someone living with dementia with activities of daily living (ADL). This program features dressing, eating, using the bathroom, and mobility, transferring and positioning. CNAs first learn the CARES® 5-step method to respond to dementia-related behavior and challenging situations.

This program does not attempt to teach better skills in performing these activities of daily living. Instead, it focuses directly on how care must change when caring for someone living with dementia. Very small changes in how care ADL care is provided make the total difference in having a pleasant, successful experience vs. possibly getting yelled at, sworn at, bitten, or even punched.

• CARES® Activities of Daily™ Living 4-hour training is provided by HealthCare Interactive CARES®.

• Cost, when taken with pre-requisite CARES® Dementia Basics™ is $159 total, curriculum and CEUs included.

• Self-paced, total 8-hour online training and satisfactory return demonstration of skill competencies.

• Training time 8 – 10 hours, includes:

• Dementia Care Basics™ (4, 1-hour modules) – see above “pre-requisite"

• Activities of Daily™ Living (4, 1-hour modules)

  • This program focuses on the activities of daily living (ADLs) across all levels of thinking decline (early-stage to late-stage) in the challenging care areas of eating, toileting, and bathing. 

Course objectives (sample):
After the course the student will be able to:

• Describe ways to make a person with dementia feel more comfortable getting dressed.

• Understand how eating abilities change at the different stages of dementia.

• Consider the impact of dementia when caring for other chronic illnesses.

• List two reasons why it’s important to help a person with dementia continue to use the toilet as independently as possible.

• Describe how proper transferring and positioning are important to the health and well-being of people.

CUSP facilities will have a licensed nurse overseeing each program level to ensure CNAs’ have provided a satisfactory return skill demonstration and that the intent and integrity of each program level is incorporated into the facility day-to-day workplace culture and care delivery protocol.

• Level II – Preceptor cost $99, curriculum and CEUs included.

• Level III – Restorative Nursing Assistant cost $99, curriculum and CEUs included.

• Level IVa – Dementia Specialty: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Activities of Daily Living. Supervisor training is discounted to $359 each. Curriculum and materials with CEUs are included. (10-12 hours)

• Level IVa – Behavioral Health: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Behavioral Health Specialty. Supervisor training is discounted to $359 each. Curriculum and materials with CEUs ar

• Level IVb – Dementia Specialty: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Activities of Daily Living. Supervisor training is discounted to $359 each. Curriculum and materials with CEUs are included. (10-12 hours)e included. (10-12 hours)